Bacopa Interfering with Xanax Metabolization via Inhibition of Cytochrome P450

2021.10.16 01:04 EruditePolymath Bacopa Interfering with Xanax Metabolization via Inhibition of Cytochrome P450

With Bacopa, the usual fear is that, by inhibiting cytochrome P450, it can prevent the metabolization and thus the elimination of certain antidepressants and anti-psychotics, leading to a potential overdose. [1]
[1] See: "Bacopa Side Effects" https://www.superfoods-scientific-research.com/medicinal-herbs/bacopa-side-effects.html
However, I found nothing regarding bacopa and xanax despite search on numerous search engines. However, it is my personal experience that bacopa interferes with the metabolization of xanax (which I take on rare ocassions for chest pains and panic attacks).
Alprazolam (xanax) is metabolized by Cytochrome P450 into alpha-hydroxy alprazolam (alpha-OHALP, pharmacologically more active) and 4-hydroxy alprazolam (4-OHALP, pharmacologically less active). [2]
[2] https://pubmed.ncbi.nlm.nih.gov/12196913/
I've been taking Bacopa for a few days now, and I just tried taking xanax for an acute case of anxiety, and I felt nothing. Took a second xanax an hour later. Still felt NOTHING.
So I suppose I'll need to discontinue Bacopa despite its blood flow improving and neuroprotective effects against the type of damage benzodiazipines can do to the brain. Luckily, I take other neuroprotective supplements (like Gingko Biloba and Acetyl-L-Carnitine) that do not interfere with Cytochrome P450 activity.
So, just a warning: if you are prescribed xanaz (i.e. alprazolam) for panic attacks or for chest pains (angina) resulting from hypoxia (lack of blood flow, which can be induced by extreme stress or anxiety), you likely want to avoid taking Bacopa as it will interfere with your metabolization of the drug. It may still work to some degree, I don't know, perhaps in a few hours I'll feel it kick in. I'll report back later with any changes.
But yes, two hours later, and I can't feel it and my anxiety is still here an hour later and my chest pains had to be subdued with nitroglycerin. So, yes, if you take any other prescription drug that is critical for your life or well being, be very wary of Bacopa because it's not thoroughly well researched and we don't yet know all the ways it changes how specific prescription medications and other supplements may be metabolized. It may also inhibit other metabolic enzymes. We simply don't know yet with the current literature.
I'll have to be content with my valerian root, lemon balm, passion flower, and chamomile, which are all anxiolytic and improve sleep, until the Bacopa gets out of my system. Luckily I wasn't experiencing a panic attack and I have my nitroglycerin as a backup for my chest pains (though, I cannot take it too often or it builds up tolerance and becomes inneffective, so I usually save it more severe cases of hypoxic pain so it will be as potent as possible.)
I read that Bacopa may interfere with the metabolization of certain drugs, so I was afraid to take it, but I tried it and it gave me very beneficial effects for the first few days. My actual concern was that it might make my alprazolam too potent, which wasn't too big a concern as I only take 0.5mg and if it lasted too long in my system, the worst case scenario I imagined is that it would put me to sleep and I'd wake up groggy the next day. I didn't imagine it might prevent alprazolam from working properly by preventing it from being metabolized into alpha-hydroxy alprazolam (alpha-OHALP).
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