Last week I wrote about the importance of sunlight in maintaining mood and generally wellbeing, and this is especially important during the darker winter months. Those lacking exposure to sunlight can run the risk of suffering from seasonal affective disorder SAD), sometimes referred to as the ‘winter blues’, and exposure to sunlight and/or light from a sunlight simulation lamp can protect against and combat this condition quite effectively.
Another approach to treating SAD is antidepressants, of course. These come in a number of different forms, both pharmaceutical and more natural. Certainly one of the most widely recommended natural options for depression (whether seasonal or not) is the herbal medicine St John’s Wort (hypericum perforatum). as a long history of use as a medicinal herb for the treatment of depression. This is also one natural remedy for which a fair evidence-base exists, with several studies showing that it does indeed have some capacity to combat depression.
The available science in the area was recently reviewed by researchers from the Cochrane collaboration (an international group of researchers specialising in systematic reviews of health interventions). This review assessed the results from 29 individual studies which included a total of about 5500 individuals. Individuals in these studies were generally suffering from mild to moderate depression. St John’s Wort was pitted against either a placebo or conventional antidepressant for periods lasting 1 ” 3 months.
The researchers found that, overall, St John’s Wort was more effective than placebo in relieving depression, and about as effective as conventional antidepressants. Compared to conventional antidepressants, St John’s Wort turned out to be significantly less likely to cause adverse effects. Specifically, those taking the herbal remedy in these studies were about half as likely to drop out of the study due to adverse effects compared to individuals taking antidepressants known as selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil, Seroxat).
This review lends strong support to the use of St John’s Wort for the treatment of mild to moderate depression. Below, I have added a previously published article which discusses, among other things, the recommended dosage of St John’s Wort and the conventional medications it may interact with.
Linde K, et al. St John’s wort for major depression. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD000448. DOI: 10.1002/14651858.CD000448.pub3.
Herbal help for depression in the form of St John’s Wort – 6 March 2005
In a previous column I highlighted the unhappy association between antidepressant use and heightened risk of suicidal behaviour in children and adolescents. Evidence has just come to light which suggests that this link may not be confined to the young. Research published recently in the British Medical Journal shows that the taking of selective serotonin re-uptake inhibitor (SSRI) type antidepressants (which includes fluoxetine (Prozac) and paroxetine (Seroxat)) may double the risk of suicide attempt. In light of this evidence, the acting editor of the BMJ questioned how many people who have turned to ‘happy pills’ would not have done so if they had been fully aware of the risks.
I should imagine that the publication of evidence pointing to the potentially hazardous nature of antidepressants will have a fair few individuals considering alternative ways to meliorate their mood. As luck would have it, just a week prior to the publication of this study in the BMJ came cheerier news in the same journal: German researchers have found that the herb St John’s Wort (hypericum perforatum) is at least as effective as the drug paroxetine in relieving moderate to severe depression. Not only that, but the herb’s capacity to induce side-effects was substantially lower that that of the conventional drug too.
This latest research is actually the latest in a mass of evidence which shows St John’s Wort has the capacity to put a smile on the faces of those seeking a relatively natural remedy for their depression. Several studies have found this herb to be more effective that placebo (inactive medication) and about as useful conventional antidepressants in relieving depressive symptoms. However, previous studies have only really assessed the ability of St John’s Wort to relieve depression that is mild to moderate in severity. What is noteworthy about the recent BMJ study is that its results suggest that the herb may be of benefit to those with more severe depression too.
Scientist’s believe that St John’s Wort antidepressant actions is largely attributable to two compounds known as hypericin and hyperforin. Extracts of the herb have been shown to potentiate the feel-good brain chemical serotonin in a way reminiscent of the SSRI drugs. In addition, St John’s Wort appears to boost the effect of other chemicals that are believed to have a broadly antidepressant action including noradrenaline and dopamine.
Although generally safe, St John’s Wort does have the capacity to increase the metabolism and therefore reduce the effectiveness of the some drugs, specifically indinavir, cyclosporin, theophylline, digoxin, warfarin and the birth control pill. Individuals taking these drugs should use St John’s Wort under medical supervision. The normal recommended dose of St John’s Wort is 300 mg of extract, taken three times a day. Benefits are usually apparent within 2 – 4 weeks. Those on conventional antidepressant medication should not stop or reduce this without first consulting their doctor. That said, it is clear that considerable evidence suggests that for those seeking a natural alternative to conventional antidepressants, St John’s Wort is certainly worth bearing in mind.