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St. John's Wort

By Lynna Landstreet

Posted on the "Medication & Treatment Questions" forum at Wing of Madness,
Wed, May 16, 2001.

Posted by another forum member:

5-htp or st.johns wort — i was wondering if anyone has tried those alt.meds and if they helped any?

My reply:

I've been taking St. John's Wort (a.k.a. Hypericum) for about two years, ever since I lost my drug plan and was no longer able to afford Zoloft. I've found it's good for mild, long-term depression, but I wouldn't rely on it in a crisis situation.

It is not as strong as most chemical antidepressants, at least not in the dosage that's usually prescribed (the same one used in most of the clinical trials, 300 mg standardized at 0.3% hypericin 3 times a day). According to my doctor, that's equivalent in its effect to the minimum maintenance dose of Zoloft or Paxil -- so obviously if someone's depression is intense enough that they're taking a higher dose, then switching to St. John's Wort would not be a good idea.

Why not just take more St. John's Wort to get a stronger effect? Because of the photosensitivity that someone else in this thread mentioned. At the usual 3/3/3 dosage, this side-effect is kept to a pretty manageable level. If you wear sunscreen and sunglasses on bright days, you'll be fine. But if someone were to double or triple the dosage to try to replicate the effect of a high dose of Zoloft or something, the photosensitivity could increase to dangerous levels. There have been cases of sheep and cows dying of sunstroke after grazing on it.

About that recent study several people mentioned -- its findings are being completely blown out of proportion, not just here but in the media generally. What it showed was that St. John's Wort was not effective in cases of severe depression. But the thing is, it's never been recommended for that! Every clinical trial that has ever been done with it previously was with mild to moderate depression, and that is all that it is generally prescribed for. Naturopaths, and MDs who are knowledgeable about alternative medicines like mine is, never prescribe it for severe depression, so saying it doesn't work for that isn't exactly news. There have been several studies showing that it is at least as effective as regular antidepressants for mild to moderate depression.

My own experience with it has been pretty good, as has that of most people I know who've taken it as directed, for mild to moderate depression. So if that's what you're dealing with, it's definitely worth a try. But if your depression is more severe, you're probably better off sticking with the SSRIs.


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