St. Johns Wort, Depression Liftef

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St. Johns Wort

(Depression liftefT)

There's been an explosion of interest in this shrubby perennial over the last couple of years, so much so that health-food stores have had trouble keeping bottles of St. John's wort in stock. This is one trendy development that I see as good news, having long championed St. John's wort as a safe and effective means of treating depression. To my mind, enough evidence is in to support the use of St. John's wort as a viable treatment for mild to moderate depression, as well as the symptoms of seasonal affective disorder (SAD). It has not yet been tested on major depression, however, so if you're severely depressed, I'd strongly advise that you seek help from a mental-health professional.

HISTORY & RESEARCH

Used in folk medicine for 2,400 years, St. John's wort is named for the feast day of St. John the Baptist in June, when its bright yellow flowers bloom. It has been widely used in Europe in recent years as a treatment for depression, with prescriptions for it in Germany now outnumbering Prozac's some 25 to 1.

There is a growing body of evidence to justify such widespread clinical use: One 1996 meta-analysis in the prestigious British Medical Journal looked at 23 randomized trials of the plant involving 1,757 depressed patients and concluded that the herb worked just as well as standard antidepres­sants, while causing far fewer side effects. A sin­gle-blind German study indicated that it may be effective for seasonal affective disorder (SAD) as well. Meanwhile, in this country, a three-year, $4.3 million trial of the herb, initiated by the National Institute of Mental Health (NIMH) and the National Institutes of Health's Office of Alternative Medicine (OAM), is currently under way at Duke University Medical Center.

                  

• Look for an extract in capsule form standardized to contain 0.3 percent hypericin—this is the type used in most studies.

• For a list of reliable brands and sources, you may want to refer to the book Hypericum & Depression by Harold Bloomfield, M.D. (Prelude Press, 1996) or check out Dr. Bloomfield's Web site at www.hypericum.com.

The optimum starting dose of St. John's wort based on medical studies is 300 mg of the standardized extract three times a day, with food. Don't expect instant results, however: St. John's wort takes longer than prescription antidepres­sants to reach optimum effectiveness, with improvement in symptoms generally noticeable after six weeks of daily use. Side effects tend to be mild and infrequent, but if you notice any gastric upset, itching, restlessness, or fatigue, try lowering your dose to give your body a chance to adjust. If this doesn't work, dis­continue use—side effects will disappear soon after you stop taking the herb.

KLUUUQ St. John's wort will in high doses cause photosensitivity: The only known fatalities caused by the herb occur in sheep who ingest massive quantities of the flowers, then stand out in the sun. If you're sensitive to the sun, use extra sunscreening precautions while ingesting this herb. Even more important is that you work with a doctor on making a gradual transi­tion if you're already taking prescription antidepressants: Don't stop or change your prescription dose without consulting your practitioner (the "rebound" effect can be severe) and don't combine St. John's wort with other antidepressants. We just don't know much about such interactions.