Review finds herbal remedy effective for the treatment of depression

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.

6 Responses to Review finds herbal remedy effective for the treatment of depression

  1. maja 11 October 2008 at 10:16 pm #

    Is St John’s Wort safe to use while breast-feeding?

  2. helen 12 October 2008 at 7:57 pm #

    It would be wise to keep in mind that feeling overwhelmed, disappointed with life choices, grief and the occassional period of sadness is not an illness most of these things pass in a very short time & it is totally irresponsible for any medical person to prescribe drugs for people because those “icky” emotions are just not nice! being perpetually happy is not even normal & is a state that can only be achieved by using drugs! most of these drugs for the so called disease (there isn’t even a test to diagnose this manufactured illness) of depression are dangerous & can cause people to lose themselves forever! being depressed is a by-product of thinking you have no right to be angry about life’s differing situations – when you feel hopeless & helpless you really only need to get angry for a little while to stop feeling helpless & then when you realise that no one can take your power away from you unless you let them you can move up the emotional scale without the use of mind numbing drugs if you can’t feel you can’t get feeling better.

  3. Steve 13 October 2008 at 7:23 pm #

    My wife took St John’s Wort for depression some years ago. While she felt that it had a beneficial effect she found that it also made her eyes more sensitive to light. Has anybody else had the same experience?

  4. lara 15 October 2008 at 4:34 pm #

    Is there anything as affective as St Johns Wort, because i am on the contraceptive pill i have been advised not to take it, but i want something natural before i go down the road of prescribed drugs


  5. Nyomi 5 April 2009 at 8:14 pm #

    Great blog. It’s great to read in this blog that St John’s wort caused less adverse affects than conventional medication for depression.

  6. nitroglycol 24 May 2009 at 8:15 am #

    I’ve certainly heard that St. John’s Wort is comparable to SSRIs in its effectiveness, at least for mild to moderate depression. Unfortunately, there are some reports that placebos are comparable to SSRIs in their effectiveness as well. So where does that leave us? Maybe SSRIs as well as St. John’s Wort are primarily effective through the placebo effect.

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