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| Is St. John's Wort a Good Remedy for Depression? |
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St. John's wort is one of the most popular herbal supplements sold in
American today. And its effectiveness is the subject of numerous studies.
Recently researchers compared St. John's wort to imipramine, a commonly
prescribed antidepressant. Over 250 people with moderate depression took daily doses of St. John's wort,
imipramine, or placebo for two months. After six weeks, St. John's wort was
shown to be at least as effective as imipramine. Even more, the people taking
St. John's wort had less than half the number of side effects than those taking
imipramine. This study appears to strongly support using St. John's wort as an
effective and more agreeable treatment for moderate depression. But before you
run out to the pharmacy there are few important things to consider. Even though herbal remedies are available over-the-counter, they are not
always safe for everyone or in every circumstance. Several studies have drawn
attention to the way that St. John's wort interacts with other drugs. It appears
that St. John's wort reduces the effectiveness of many prescription drugs used
to treat heart disease, depression, seizures, and certain cancers. Also included
are drugs used to prevent conditions such as transplant rejection or pregnancy.
For example, it may be counterproductive or even harmful to take St. John's wort
if you are also taking digoxin, coumadin, or oral contraceptives. Recently, a
study conducted by the National Institutes of Health showed that St. John's wort
greatly reduced the effectiveness of indinavir, a protease inhibitor used to
treat HIV infection. Researchers suspect that St. John's wort may have this
effect on all HIV protease inhibitors. You should also be aware that the government does not regulate the
manufacture of herbs or supplements. As a result, the amount of active
ingredients in an herb or supplement capsule may vary from brand name to brand
name, or even within a single brand. In other words, one brand of St. John's
wort may be more helpful in treating your depression than another. The bottom line: St. John's wort has been proven to be a successful
alternative therapy for moderate depression. However, it is a powerful herb that
can significantly affect other medications. Be sure to talk to your doctor first
if you are considering using St. John's wort. If you do decide to try St. John's
wort, it may be smart to look for a standardized product that complies with U.S.
Pharmacopeia (USP) standards. |
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| References |
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Center for Drug Evaluation and Research. FDA Public Health Advisory: Risk of
drug interactions with St. John's wort and indinavir and other drugs. February
10, 2000. Available at http://www.fda.gov/cder/drug/advisory/stjwort.htm. Ernst E. Second thoughts about safety of St. John's wort. Lancet.
1999;354:2014-2016. Johne A, Brockmöller J, Bauer S, Maurer A, Langheinrich M, Roots I.
Pharmacokinetic interaction of digoxin with an herbal extract from St. John's
wort (Hypericum perforatum). Clin Pharmacol Ther.
1999;66(4):338-345. Philipp M, Kohnen R, Hiller K-O. Hypericum extract versus imipramine or
placebo in patients with moderate depression: randomised multicentre study of
treatment for eight weeks. BMJ. 1999;319:1534-1539. Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir
concentrations and St John's wort. Lancet.
2000;355(9203):547-548. |
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| Review Date: March 2000 |
Reviewed By: Integrative Medicine editorial
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Copyright © 2004 A.D.A.M., Inc
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed
herein.
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