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.

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