St John’s wort became popular quite a few years ago based on its ability to effectively manage depression.  Further clarification in the medical literature confirmed this ability, but generally for mild to moderate depression.  But how does it compare to prescription meds?

I do need to mention that there was some attempt to disparage use of St. John’s wort because it interferes with some heart medications because it speeds up one of the enzymes that breaks down some heart medications.  So avoid at all costs, right?  These sensational news articles neglected to mention that pretty much every prescription antidepressant on the market ALSO effects these same enzymes.  Conveniently omitted.

First, let’s get something straight.  For the vast majority of patients taking antidepressants, the results compared to placebo just plain suck.  That’s not to say that some patients could not function without them.  But the majority of patients do not benefit beyond a placebo effect.  Of course, the placebo response, when it comes to antidepressant clinical trials, is pretty darn potent.  On the range of 40-50% response rates.

Of course, the placebo does not increase your risk of diabetes (like the SSRIs) or increase the risk of suicidal ideation or in general zone out your brain.

Then, we can compare the effects of exercise and fish oils on depression and overall neurological function, which is again, quite powerful.  Throw in some meditation to boot and you’re well on your way to improving your brain.

This particular study takes an interesting approach.  Few trials of natural agents go head to head against prescription drugs for fear of the FDA coming back at the natural agent and trying to regulate them (saw this early on with red chinese yeast rice).  This study compares the effects of St. John’s wort extract (hypericum) against citalopram (Celexa) for mild to moderate depression.

The results?  The hypericum users had a lower relapse rates than the citalopram users AND the duration of treatment response was 100 days longer in the hypericum group.  Not too shabby.

The only thing I would add would be to make sure you get your herbs from a reputable source and not off of the internet.

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James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.