ST. JOHN'S WORT

Nature’s Happy Pill

At least 1 in 20 Americans get depressed every year. Many rely on antidepressants to help them cope. Many studies show that the herb St. Johns wort may be just as effective, and with fewer side effects. The August 3rd, 1996 issue of the British Medical Journal contains an analysis of approx. 25 studies that suggest Hypericum perforatum is just as helpful as many commonly prescribed antidepressants without such side effects as headaches or vomiting. Dr. Cynthia Murlow, one of the study’s authors, says the findings are not surprising. “Some of the commonly used medicines have a basis on herbs or a basis in plants, and some of the ones were developed using plants.” Although not well known in the USA until recently, researchers in Europe have been studying it for decades. Doctors in Germany have been prescribing it for depression and insurance companies have been paying for it. It is available in herb shops in Europe and the USA, but recently it has been increasingly selling out as the word travels about its effectiveness It is available in whole, dry form, liquid extract or tincture form, and in capsules.

Clinical Studies:

Not long ago, experiments were done where mice infected with viruses similar to FIIV were given St. Johns wort. The progress of development in the virus was halted. This led to testing on human HIV and AIDS patients. The results were inconclusive, though anecdotal information reports a significant improvement in some patients. St. Johns wort contains hypericin that inhibits monomine oxidase, a bodily chemical associated with depression. It appears that hypericin does not act alone. Like many herbal medicines, it relies on the complex interplay of many constituents for its antidepressant action. Patients suffering from debilitating depression received relief, increased appetite, and more interest in life, greater self esteem, and restoration of normal sleeping patterns. In a multicenter trial, 135 patients with clinical depression were given either St. Johns wort (900mg/day) or imipramine (75mg/day) for six weeks. Therapeutic success was determined using the HAMD, clinical global impression (CGI), and the depression scale according to Zerssen. HAMD scores improved by 56% in the St. Johns group, compared to 45% in the imipramine group. Differences in the CGI and Zerssen scales were slightly better in the St. Johns group, although not significantly different. Adverse reactions were reported in 16% of the patients taking imipramine while only 11% of those taking the St. Johns won reported any side effects at all. Hypericum was recommended by Hippocrates for “nervous unrest” it has a 2400 year history of folk use for anxiety, slight disturbances. and worry. The official German Commission E monograph for St. Johns wort lists psychovegetative disturbances, depressive states, fear, and nervous disorders as clinical indications for the extract. Clinical studies have shown significant improvement in symptoms of anxiety, apathy, hypersomnia, insomnia, anorexia, psychomotor retardation, depression, and feelings of worthlessness.

Safety:

Hypericum should not be combined with a MOA inhibitor antidepressant such as Nardil (pheneizine) or Parnate (tranylcicypromine). This combination can cause a dangerous rise in blood pressure or hypertensive crisis, along with severe anxiety, fear, muscle tension, and confusion. After stopping an MAOI, one should wait at least four weeks before taking other antidepressants, including hypericum. There are some recent reports that suggest interference with certain medications given during organ transplant (such as kidney or liver). Do not take this herb if you have undergone or plan to undergo a transplant operation. Avoid foods and medications that are known to interact with MAOI’s. Tryamine containing foods (red wine, cheese, beer, yeast, and pickled herring) and drugs such as L-DOPA, and 5-HTP should be avoided. St. Johns wort should not be taken at the same time as any prescription antidepressants, and never while pregnant or while nursing. St. Johns wort does make the skin more light sensitive. Persons with fair skin should avoid exposure to strong sunlight and other sources of ultra violet light, such as tanning beds. These individuals may experience dermatitis, severe burning and possible blistering of the skin. The severity of these effects will depend on the amount of plant consumed and the length of exposure. St. Johns wort has an excellent track record of safety. In contrast to synthetic antidepressants, there have been no reports of hypericum-related deaths. Drug monitoring studies on over 7000 patients and over 30 double blind studies confirm its safety. Also, the extended use by millions of people all over the world have not resulted in any reports of severe side effects. The most common, all be it limiting, side effects reported include, gastro- intestinal irritation, dizziness, dry mouth, and few mild allergic reactions. All of these symptoms subside immediately with discontinued use. It is important to know that less than 5% of all people stop taking hypericum because of unwanted side effects. The therapeutic dosage of hypericum is 300mg 2 to 3 times per day. It is recommended to start at the lowest dose possible and only increasing the dose as needed to reach full efficiency. It may take up to 6 weeks to reach full results, but many people report noticeable changes within the first week of use.