But, let’s start out by personalizing the question posed in the title. Will St. John’s Wort effectively cure your depression? The short answer to this question is:  it depends.  Sorry if you were hoping for a simple yes or no answer, but when it comes to depression or to any mental health issues for that matter, you rarely find magic bullet cures.  The complexity of the issue is better addressed by further rephrasing the question:  When is St. John’s Wort most likely to be effective for depression?  

 

First, let’s look at the proposed treatment for depression:  St. John’s Wort. St. John’s Wort goes by the scientific name of Hypericum Perforatum. It is a wild-growing plant with yellow flowers. It has been used for thousands of years in herbal, homeopathic, folk, and ancient medicine as a treatment for a variety of problems, including what we nowadays call depression and anxiety. Hippocrates, the “Father of Medicine” from ancient Greece, prescribed St. John’s Wort! Unfortunately, Hippocrates won’t be of much help to us in our current quest because he prescribed St. John’s Wort not for depression, but for demonic possession.  

 

Still, St. John’s Wort as a treatment for depression has gained some respectability in modern times. It is widely used as a treatment for depression around the world, and especially in Europe. In Germany, according to hypericum.com, it is used as the treatment of choice for depression, anxiety and sleep disorders 50% of the time, more than any prescription medication. In contrast, Prozac is prescribed only 2% of the time for these disorders. 

 

Carefully controlled, double blind studies have demonstrated that Hypericum (i.e., St. John’s Wort) is just as effective as prescription medications, and more effective than a placebo (a pill with no active ingredients). Furthermore, in several studies St. John’s Wort was found to have fewer side effects than the prescription medications. To add to these benefits, compared to prescription medications, St. John’s Wort is cheaper—about 25 cents per day.

 

St. John’s Wort supplement is basically an extract of the essential oils from the flowers, leaves, and stems of the St. John’s Wort plant. St. John’s Wort has been classified as a dietary supplement, and not as a drug. Therefore it is not regulated by the FDA.

 

However, don’t be lulled into believing that because St. John’s Wort is derived from a naturally occurring form of wildlife and is not regulated by the FDA that it is not a drug. Technically, any substance that contains chemicals that you eat, drink, inhale, shove up your nose, put in your eyes, suck, inject or rub on yourself that affects your body is a drug. As any chocoholic knows, even food is drug. Many biologically active pharmaceuticals are modeled after or actually include naturally occurring herbs and plants.

 

Folks, call  St. John's Wort an herbal supplement. Call it a plant. Call it what you want, but it is a drug. It is a non-regulated medication. In particular St. John’s Wort can be considered to be an antidepressant. 

 

There are several classes of antidepressants, each defined on the basis of how they affect neurotransmitters, the chemical messengers in the brain. St. John’s Wort has the same properties as a particular class of anti-depressants--MAO inhibitors (e.g., Parnate, Nardil). It is low-grade compared to prescription medications, but it essentially has the same psychotropic actions as prescription MAOIs. 

 

People who are depressed seem to respond differently to different types of medications. For example, some respond best to MAO inhibitors, some respond better to SSRIs (such as Zoloft, Prozac, Paxil) and others respond better to SNRIs (e.g., Effexor, Serzone). 

 

This only makes sense. We are each bio-chemically unique beings. We respond differently to different things. Did you know that some people don’t respond to morphine? Due to their particular DNA they lack the cells that produce an enzyme that is necessary to break down the morphine into a chemical form that can be used by their nervous system. Similarly, you must know someone who can’t tolerate nuts, has an allergic reaction to shell fish, or gets indigestion when they use dairy products. So, people respond differently to foods, and respond differently to medications. Some people respond better to St. John’s Wort because they respond better to MAOIs.  

 

Another important consideration for the use of St. John’s Wort is the treatment regimen. Like most anti-depressants, St. John’s Wort must build up over time in the blood system in order to have a therapeutic effect. It takes 3 or 4 weeks of using it before one can determine if it is therapeutically effective. 

 

Also, like any other medication, figuring out what dosage will be effective is important. People have different body weights, different metabolisms and different tolerances, so they may require different levels of medication. The goal is to start out at the “conventional” accepted minimum treatment dose (300 mg three times daily), then gradually increase to a level that is effective, following recommended guidelines. That is a topic for a different article.

 

However, just because St. John’s Wort is a so-called “herbal” treatment, don’t ignore the fact that we are talking about biochemical treatment of a major illness. Dosing is an issue that will determine the effectiveness of the intervention. Taking herbal supplements is like taking drugs. 

 

So, medicinal plants like St. John’s Wort are drugs. Folks, be prudent in what you eat, drink, inhale, shove up your nose, put in your eyes, suck, inject or rub on yourself--even if it’s a plant. Make sure you’re subjecting your body to the drugs that are going to be helpful. Don’t take drugs unnecessarily. Don’t take drugs when their potential risks outweigh their potential benefits.    

 

These are the critical issues that will be the subject of Part II.  That’s why, even though this article seems to be way-long and, like the energizer bunny, it keeps going and going, it is important that you grit your teeth, and forge on. Let’s figure out when St. John’s Wort may be the medication of choice, when it probably won’t help, and when you want to avoid it. 

 

To see the exciting conclusion of this article, click here to go to Part II: http://www.xomba.com/st_john%E2%80%99s_wort_effective_depression_part_ii