St. John's Wort is an attractive perennial with yellow flowers that smells like turpentine or balsam. If you bruise the flowers, they yield a reddish juice. The plant grows in Europe, Canada and the US.
According to Rodale's Illustrated Encyclopedia of Herbs , for centuries it was thought to drive out devils. Later, St. John's Wort was associated with St. John the Baptist and said to bleed on his birthday.
Hypericum contains at least 10 groups of components that contribute to its effects. One of them, hypericin, inhibits monamine oxidase, which breaks down neurotransmitters in the brain. Thus hypericin contributes to the antidepressant effect, but other components are involved as well.
The British Medical Journal editorial commented on a comprehensive overview of 23 randomized trials on St. John's Wort published in the same issue. The authors concluded that hypericum extracts were more effective than placebo for the treatment of mild to moderately severe depressive disorders. However they cautioned that, "we do not know yet if hypericum is better in treating certain depressive disorders than others."
The researchers also reviewed six studies that compared hypericum to tricyclic antidepressants and tranqilizers, and found it to be equally effective. However, it is worth noting that none of the studies lasted longer than six weeks, and the doses of tricyclic antidepressant drugs used were low normal or less than normal.
Naturopathic physician Dr. Michael Murray says in his book, Natural Alternatives to Prozac (Morrow 1996), that St. John's Wort is the most thoroughly researched natural antidepressant. He reports that 1,593 patients have been studied in twenty five double-blind studies.
Photosensitivity has been reported in white haired animals taking 30 to 50 times the therapeutic dosage, but otherwise the herb has a good safety profile. A large German study of 3,250 patients showed a 2.4 percent incidence of side effects, minor compared to most antidepressant drugs. Like synthetic antidepressants, hypericum takes two to four weeks to develop its effects.
Other important aspects of a holistic approach to depression include improving the overall diet, eliminating coffee, alcohol, sugar, sugar substitutes, regular exercise, and learning some stress management technique like meditation. Food allergies are important and can be determined through an elimination diet. There are often nutritional factors in depression. Deficiencies of folic acid, vitamin-B-12 vitamin-B-6 and essential fatty acids are very common.
A high quality multi-vitamin and mineral and extra mega-B-vitamins, flax seed oil are recommended for any person with depression, and will not interfere with medication. If you are currently on antidepressant medication, consult with your doctor first before suddenly going off the medication.
A prescription amino acid known as tryptophan has a mild antidepressant effect of its own, is helpful for insomnia and also increases the effect of antidepressant drugs.
Cognitive Therapy (CT) involves observing and altering habitual thought patterns that lead to predictable emotional reactions. CT has been studied in double blind trials and shown to be as effective as antidepressants for mild to moderate depression. In addition, it may have a lower relapse rate than drug therapy. Although it is ideal to have a therapist, cognitive therapy can be learned though books like psychiatrist David Burn's book, Feeling Good Again Handbook (Plume 1990).
One thing is clear. Although promising, there is not enough evidence yet to conclude that St. John's Wort can be used alone for the treatment of serious depression. For that kind of depression, drug therapy is still indispensable.
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