If you or someone you know suffers from depression, you are not alone. According to statistics from the National Institute of Mental Health, depression affects more than 18 million adult Americans each year. But according to a 2003 Harvard Medical School study, many patients don’t have positive results with mainstream treatments.1
Pharmaceutical drugs are expensive and come with an array of possible side effects, which are two reasons that patients often abandon this treatment. St. John’s wort extract has been recognized for its ability to help balance mood, often caused by low levels of the neurotransmitters serotonin and norepinephrine. Here are some of the latest research findings regarding St. John’s wort:
St. John’s wort, (Hypericum perforatum) works as well as the major antidepressant drugs for treating mild to moderate depression. A recent German study of St. John’s wort reviewed 29 studies in 5,489 patients with depression that compared treatment with extracts of St. John’s wort for four to 12 weeks with placebo treatment or standard antidepressants. The studies came from a variety of countries, tested several different St. John’s wort extracts, and mostly included patients suffering from mild to moderately severe symptoms.
The researchers found that it was superior to placebo in patients with major depression, effective as standard antidepressants, and had fewer side effects than standard antidepressants. Additionally, it was better tolerated than pharmaceutical drugs. Patients who were given hypericum extracts dropped out of trials less frequently due to adverse effects than those given antidepressants.2
An article recently published in a Hebrew medical journal discussed the history of St. John’s wort through the present, a meta-analysis, details of clinical trials that were published in 2005-2006, and the mechanism of action. In summary, the use of St. John’s wort was first described in the time of Hippocrates and it has been used as an antidepressant since the 1500s. In the last 20 years, the use of St. John’s wort for treating depression has entered the arena of conventional medicine.
In Germany, for example, St. John’s wort is prescribed four times as often as Prozac for depression.
Many articles have been published on the efficacy and safety of St. John’s wort in treating mild to moderate depression, including a meta-analysis that was published in 2005 in the British Journal of Psychiatry. This meta-analysis summarized the results of 37 studies that were conducted on 5,000 subjects, comparing St. John’s wort to placebo and other antidepressants. The authors of the meta-analysis concluded that St. John’s wort products are effective in the treatment of mild to moderate depression with fewer side effects compared to traditional antidepressants. In cases of severe depression, insufficient evidence was found on St. John’s wort efficacy.3
Safe during pregnancy and breastfeeding
Two studies have found that St. John’s wort is safe for pregnant and nursing women. The first study on the effects of St. John’s wort in human pregnancy was recently done at The Hospital for Sick Children in Toronto, Canada. The researchers assumed that because a significant proportion of pregnancies are unplanned, some women are exposed to St. John’s wort before they realize they are pregnant.
The purpose of their study was to determine whether exposure to St. John’s wort during pregnancy is associated with major malformations. The researchers collected and followed subjects taking St. John’s wort and compared them to a matched group of pregnant women taking other pharmaceutical drugs for depression and a third group of healthy women, who were not exposed to any known teratogens (agents that cause birth defects).
Fifty-four women who took St. John’s wort were followed, as well as 108 pregnancies in the two other groups. The results in all groups were similar, showing a 3-5% risk of malformations, which is expected in the general population. The live birth and prematurity rates were also not different among the three groups. Though further large-scale studies are still needed, this first study on the effects of St. John’s wort in human pregnancy does provide some evidence of fetal safety.4
Another Canadian study done in 2003 found that St. John’s wort is safe during breastfeeding, both for the mothers and the babies.5
Although St. John’s wort is the most common herbal remedy for depression, other important mood enhancers and stabilizers include: 5-HTP (5-hydroxytryptophan), SAMe, ATP (adenosine triphosphate), omega 3 fatty acids, B vitamin complex, and magnolia extract.
- Harvard Medical School Study
- Linde K, Berner MM, Kriston L. St John’s wort for major depression Cochrane Database Syst Rev. 2008 Oct 8;(4):CD000448.
- Baruch Y. “Hypericum extract for treatment of depression: what’s new?” Harefuah. 2009 Mar;148(3):183-5, 210, 209. [Article in Hebrew]
- Moretti ME, Maxson A, Hanna F, Koren G. Evaluating the safety of St. John’s Wort in human pregnancy. Reprod Toxicol. 2009 Jul;28(1):96-9. Epub 2009 Feb 24.
- Lee A, Minhas R, Matsuda N, Lam M, Ito S. The safety of St. John’s wort (Hypericum perforatum) during breastfeeding. J Clin Psychiatry. 2003 Aug;64(8):966-8.