Question: You are the only pharmacist we know who is familiar with natural remedies and who thinks too many people take too many drugs. I agree wholeheartedly. Unfortunately, my husband’s psychiatrist has put him on Effexor. He wants to use Nopalea drink from a company called Trivita, which is made from cactus plant. His doctor didn’t know if it contained anything that would raise serotonin and thus be contraindicated with Effexor.

I called the company, they didn’t know. They told me to ask his pharmacist. I did, she didn’t know, and her attitude said “and I don’t give a rip.” Nobody else seems to know or care. Can you help us with this question?

Larry’s Response: Nopalea is more than cactus extract. It is predominantly fruit juice from a wide variety of fruit. In addition to the natural fruit sugars (fructose), it is sweetened with stevia. It is a very expensive fruit juice mixture ($30.00 per quart, approximately $1.00 per ounce), but still, just fruit juice. I don’t see anything in it that would cause a change in serotonin levels.

I don’t see anything about the nopalea juice that would be particularly harmful or contraindicated with Effexor. I also don’t detect anything particularly special about it either (except the marketing claims on the Internet). Juices are good at balancing our pH. They all do it, especially the citrus ones. I just don’t think including cactus juice/extract offers any particular advantage.

Fresh-squeezed juice is far superior to any packaged product. The nopalea product comes in a bottle so I presume the juices and extracts have the same kinds of negative issues that I associate with store-bought juice.

I have been involved with MLM programs in the past and I know for a fact that they always have extraordinarily high prices – someone has to pay for all of the downline people involved in the sale, and it’s always the final customer. Only a few people at the top make any significant money in these programs.

There are excellent detoxifying (flush) products on the market that have been shown effective over many years – and don’t require high costs or participating in a MLM scheme.

I hope this is helpful.