Treating Depression with St. John’s Wort – Does it work?

We often say “I’m depressed” when we’re just barely sad. Or we say “he/she’s depressive” as if we’re talking about a personality trait. But depression is a very serious condition that, when left untreated, can lead to the worst of outcomes. So if you think you or a family member or friend might be depressed, contact your healthcare provider right away and he/she’ll recommend a specialist you can talk to.

Depression can have multiple causes. It can appear both in adults and children, it can be chronic or it can appear spontaneously, it can be easily detected or its causes can remain completely unknown. That’s why treating depression is an incredibly difficult task even for specialists and that’s why self-medication should never be taken into consideration, even if you’re opting for a natural treatment.

So even if there is a good chance that St. John’s wort could be effective for you and even if you’ve received the best reviews from any friend, relative or article such as this one, you should only take it after you’ve discussed with your doctor about it. Any chemical imbalance in your body (caused by an inappropriate treatment) can potentially worsen your symptoms.

Depression – some worrying stats

  • According to the World Health Organisation, globally more than 300 people of all ages suffer from depression. At its worst, depression can lead to suicide, which is the second leading cause of death in 15-29 year olds.
  • According to a WHO report from 2008, the rate of depression is 50% higher in women than in man.
  • According to the same report, depression is the leading cause for disease burden for women in both high-income and low- and middle-income countries.
  • In USA, according to the National Center for Complementary and Integrative Health, in 2015 almost 7 percent of U.S. adults have reported having at least one episode of major depression in the past year.

St. John’s wort in treating depression – does it really work?

St. John’s wort (Hypericum perforatum) is a flowering plant native to Europe and parts of Asia. The plant got its common name from the fact that it usually blooms around saint John the Baptist’s feast day, the 24’th of June.

St. John’s wort has been used for hundreds of years for its medicinal properties and it is mentioned in some of the oldest medicine books. Teas, oil extracts, liquids and topical preparations were made out of the flowers and leaves of the plant and used mainly to heal wounds and prevent infections.

Only relatively recently, though, studies have supported the efficacy of St. John’s Wort as a treatment for depression.

According to NCCIH, St. John’s wort is considered to have limited effectiveness on depression. And while we currently have a fair amount of data regarding its short-term effects, we still know little of its long-term effects. Even so, St. John’s wort is widely recommended as an antidepressant in Germany and though it can usually be bought over-the-counter, it also has a long history of use by German medical professionals as well.

Here are the conclusions of some of the most significant clinical trials about the effects of St. John’s wort in treating depression:

  • John’s extracts are significantly superior to placebo and similarly effective as standard antidepressants;
  • St John’s extracts seem to be effective in the treatment of mild to moderately severe depressive disorders.
  • Several studies have shown that St. John’s wort is not effective in for the treatment of major depression.
  • In one study, St. John’s worth extract tablets were compared with fluoxetine, a commonly used slow serotonin reuptake inhibitor regarding their efficacy in the treatment of mild-moderate depression. The conclusion was that both are equally potent with respect to all main parameters used to examine antidepressants, but St. John’s wort was superior to fluoxetine when it came to the incidence and types of side effects reported by the patients.
  • In another study, St. John’s wort was compared with imipramine, another common antidepressant. The conclusion was that while St. John’s wort is therapeutically equivalent to imipramine in treating mild to moderate depression, patients tolerate St. John’s wort better.
  • There are very few studies conducted in the USA focusing on the efficacy of St. John’s wort in treating depression. But even if we had more data, recommending its use to patients in the U.S. would be complicated, as the Food and Drug Administration (FDA) does not classify herbal medications such as St. John’s wort as drugs. Therefore, for this purpose we would need better regulation and standardization of herbal therapies.
  • The long-term safety of St. John’s wort, or its use in pregnant women, has not been studied.

A word of caution:

St. John’s wort interacts with many types of medication, usually making them less effective. For instance, it is known to interact with birth control pills, certain cancer medications and other antidepressants. Also, it is not recommended in bipolar disorder, as it is believed to increase the risk for mania. So always consult your healthcare provider before taking it and inform him/her of any other treatment you might be on at the moment.

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