InBio MoodLift is a natural health product designed to support mood stability and alleviate symptoms of mild to moderate depression in adults. It combines two active ingredients—St. John’s Wort extract and S-Adenosyl-L-Methionine (SAMe) disulfate tosylate—to provide synergistic effects. Each enteric-coated capsule contains 300 mg of standardized St. John’s Wort extract (0.3% hypericin) and 400 mg of SAMe. Inactive ingredients include microcrystalline cellulose, magnesium stearate, hypromellose, mannitol, citric acid, sodium starch glycolate, hypromellose phthalate, and titanium dioxide.
St. John’s Wort inhibits the reuptake of serotonin, norepinephrine, and dopamine through its active constituents, hypericin and hyperforin, modulating neurotransmitter levels and receptor sensitivity. It is metabolized by cytochrome P450 enzymes (CYP3A4, CYP2C9, CYP2C19) and P-glycoprotein, which may reduce the efficacy of drugs metabolized by these pathways. Both St. John’s Wort and SAMe are excreted via urine, with St. John’s Wort also being excreted through bile. SAMe enhances neurotransmission and neuronal membrane fluidity by supporting methylation reactions essential for neurotransmitter synthesis. Administered in enteric-coated capsules, SAMe is absorbed in the small intestine and widely distributed after metabolism in the liver.
InBio MoodLift is indicated for the relief of symptoms associated with mild to moderate depression in adults. It is contraindicated in patients with hypersensitivity to St. John’s Wort, SAMe, or any excipients. It should not be used by individuals with bipolar disorder due to the risk of triggering mania or hypomania. Concurrent use with SSRIs, SNRIs, or MAOIs increases the risk of serotonin syndrome.
Both St. John’s Wort and SAMe may increase the risk of serotonin syndrome when used with serotonergic agents. Symptoms include confusion, agitation, hyperreflexia, and hypertension. If these symptoms occur, discontinue use immediately. St. John’s Wort induces cytochrome P450 enzymes and P-glycoprotein, potentially reducing the efficacy of medications such as oral contraceptives, immunosuppressants, anticoagulants, antiretrovirals, antiepileptics, and cardiovascular drugs. St. John’s Wort may also cause photosensitivity, especially in fair-skinned individuals. Patients with a history of mood disorders should be monitored for mood changes. SAMe may elevate homocysteine levels, increasing cardiovascular risk. The safety of InBio MoodLift during pregnancy and lactation is not established. Discontinue use two weeks prior to surgery due to potential interactions with anesthetics.
Common side effects of St. John’s Wort include gastrointestinal disturbances (nausea, vomiting, diarrhea), dizziness, headache, restlessness, fatigue, and dry mouth. SAMe may cause gastrointestinal upset, anxiety, irritability, and insomnia. Less common side effects include photosensitivity and, rarely, mania or hypomania with SAMe. St. John’s Wort may reduce the efficacy of medications metabolized by cytochrome P450 enzymes. SAMe may enhance serotonergic effects when used with opioids like tramadol. Anxiolytics and sedatives may have additive effects.
In the event of overdose, symptoms may include confusion, agitation, severe gastrointestinal distress, tachycardia, and hypertension. Provide supportive care and symptomatic treatment. Patients should inform their healthcare provider of all medications they are taking. Counsel them on the risk of serotonin syndrome and recommend precautions against photosensitivity. Women using oral contraceptives should be informed of potential reduced efficacy. Advise patients to avoid abrupt discontinuation and limit alcohol consumption.
References
Linde K, Berner MM, Kriston L. St John’s Wort for major depression. Cochrane Database of Systematic Reviews. 2008;(4).
Papakostas GI. Evidence for S-adenosyl-L-methionine (SAMe) for the treatment of major depressive disorder. Journal of Clinical Psychiatry. 2009;70 Suppl 5:18–22.
Müller WE. St. John’s Wort and its Active Principles in Depression and Anxiety. Birkhäuser Basel; 2005.
Butterweck V. Mechanism of action of St John’s Wort in depression: what is known? CNS Drugs. 2003;17(8):539–562.
