St Johns Wort And DepressionSt Johns Wort and depression are often spoken about in the same breath by people seeking a natural remedy. That's because it is a proven medicinal herb used for the treatment of neurological and psychiatric disorders, including depression. Compared to placebo, St Johns Wort (Hypericum perforatum extract) can effectively treat mild to moderate depression, reducing symptoms and recurrence rates. The mechanism of action between St Johns Wort and depression is not entirely clear. One idea is that St. John’s wort may increase availability of serotonin and norephinephrine making it a good natural depression herbal medicine.
Scientific EvidenceTo date, there have been case reports and drug monitoring studies in more than 5,000 patients on the efficacy and safety of standardized St Johns Wort as a depression herbal remedy.Twenty-three controlled double-blind studies have been conducted on more than 1,757 patients. Sixteen of these compared hypericum with placebo (sugar pills) and nine with drug anti-depressants. In most of these studies, depressive symptoms showed general clinical improvement, ranging from 50 to 80 percent when compared to low- to medium-dose treatment with "classic" anti-depressants. In a German study by 663 private practitioners on 3,250 patients (76 percent women and 24 percent men), the percentage of patients who showed improvement in depressive and secondary physical symptoms (ranging from fatigue, cardiac, digestive and sleep disorders, to generalized pain) was similar to previous studies, with about 80 percent of patients feeling better and only 15 percent unchanged or worse. In these studies, St Johns Wort was significantly superior to placebo and similarly effective as standard antidepressants, with significantly fewer side effects.
Dosages And PrecautionsAlthough St Johns Wort is available without a prescription, it should be used for clinical depression under the care of a physician. The evidence shows that St Johns Wort is effective remedy only for mild or moderate depression and should not be relied on for severe depression.The evidence also shows that St Johns Wort is slow-acting, and that it can take up to six weeks before it begins to relieve depression. Anyone seeking a fast-acting alternative to antidepressant drugs should consider S-adenosylmethionine (SAMe), which has been shown to have potent antidepressant effects in a week or less in some studies. The most common doses used with St Johns Wort and depression is 300 mg (standardized to 0.3 hypericum), three times a day for four to six weeks. If you find that St. John's Wort has helped you after this time, you can usually lower the dosage somewhat. If you already are taking prescription antidepressants, do not alter your dosage or combine with St. John's Wort without first consulting with your doctor. St John's Wort should not be used with MAOI's (monoamine oxidase inhibitors) such as Nardil or Parnate. There is some evidence that at least part of the action of St. John's Wort is as a selective serotonin uptake inhibitor (SSRI). Combining an SSRI with a MAOI can cause a dangerous rise in blood pressure. While many natural remedies have been shown to have a beneficial effect on illnesses, you must remember that even though they are natural substances, you need to be under supervision of a doctor trained in the treatment you are seeking (drug or natural remedy) because even natural remedies can have side effects when combined with medicine.
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