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Xiao Yao san and Gui pi tan taken together with antidepressants and anxiolitic drugs


Good day all.

I have been using your excellent site for years, teaching myself interesting things about tcm. I will try and be more precise and to the point as much as possible. I have been diagnosed with anxiety disorder plus somatisation of anxiety and stress for many years now. I have been on medications like Zanax and recently a new antidepressant called Brintelix.
My acupunturist in Greece suggested me that it would be good to try some Chinese formulas since I am in a constant yoyo effect with the drugs. I have dizziness, nausea, increased eye pressure (22mg), neck and shoulder pains and in 2016 i was diagnoed with optical nevritis, which after many many examinations they didnt find the origin. I had brain MRI tests, blood test, each year up to today and all are negative.
So, my acupunturist who is also my friend suggested i start with a combo of Xiao Yao San and Gui Pi Tang. My 1st question to him was if I will have any side effects using them together with the above mentioned drugs (more dizziness, possible gastrointestal bleeding/problems, more nausea or any other symptom and he told me that I won’t. Since you guys are more into TCM all those years, Can you also confirm or at least let me know about any possible interactions .sid effects with the above drugs mentioned or any other drugs?
I thank you in advance for your prompt reply and help into this matter.
Kind regards,


Without knowing your personally and your entire health history I can only offer generalizations. To start with certainly anxiety responds extremely well to both acupuncture and properly prescribed Chinese herbal medicine. The goal of Chinese Medicine treatment is to not only remove the need for western medications, but to remove the need for Chinese Medicine itself - i.e. to truly heal the condition. And quite often in clinical practice this is accomplished - although it may take months to years of correctly prescribed treatment.

Generally properly prescribed herbal formulas have very limited side effects, generally none. Part of this, simply, is that they are closer to food in many ways than they are medicine - which means they metabolize faster and in smaller doses and are less controlling to the body (which all limit side effects). Certainly xiao yao wan and gui pi wan are very widely used and if properly prescribed, should be very well tolerated.

As for drug/herb interactions there are very few - and more are along the lines of symptomatic changes - that is taking blood pressure medicines, then actually treating the cause of the blood pressure issues with Chinese Medicine may lead to lower blood pressure (i.e. the need for less medicine). So not a true interaction in the sense that you are implying.

The other reason there is little interaction is because the herbs are fundamentally different in most cases (i.e. working with the body) to western medicines (i.e. often doing something for the body or forcing it to do something). If anything they are often more likely to be complementary although there is generally a time where the western medicine, if at all possible, needs to be removed from the equation to see if the body can manage its own affairs. This, however, is all between your practitioner, yourself, and possibly your western doctors and it happens over time.

Certainly there is nothing that you are describing that shouldn’t respond well to proper Chinese Medicine treatment within 2-5 months.


Dear Chad.
Thanks for your very analytic response to my request / question. That really helps me clear things up in my mind. So to conclude there are no worries combining the drugs and the herbs and after some time eventually get to the point of getting rid of the western meds which are poisoning my body and mind.


Dear Panos,
Im an older acupuncturist no longer practising my needles… and used to live in Greece.
I know your country’s stress and still think you are lucky to live there.
And thats related to your physical mental situation.
Id recommend taking on a regular physical discipline like Tai chi, chi gong, or yoga. There are a bunch of good places in Athens. If youre not there ask around and test try studios near you.

If you cant afford it I’ d say find a way: clean their floors manage the front end, whatever. Because I have (past) clients in Greece still who thank me for pressing them to add in one of those disciplines.
It willl take a bit of research, talk and go try various teachers. One will make you feel at home. Go for it!:slight_smile: &geia hara!


Hello Piera and thank you for your time to write to me. Much appreciate it.
I will do as you said, in fact I’m already looking for a place to do chi gong. I live in thessaloniki BTW.
Any comments about the herbs that I wrote, interacting with drugs etc?


Chad is right and I would stop worrying. Re- read how Chad explained Chinese herbs. Or pay for an acupuncturist who is not a friend so you have more confidence. Ciao:)

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