St. John's Wort for Depression - Does it Work?

In My Humble Opinion
1

Has anyone tried this, and did you find it helpful? I’m attracted to this idea because it’s a natural herb rather than a manufactured drug.

Last year I tried Lexipro, which had too many side effects, and Remeron, which was helpful but gave me restless leg syndrome. After that, I said to hell with prescription drugs for depression and have been trying to level my moods through diet and exercise. But, that doesn’t always work, and I was thinking about trying something new when I read that St. John’s Wort can be used to treat mild to moderate depression. I thought to myself, “Perfect!”

So, I think I’m going to try it. What were your experiences with St. John’s Wort? What other benefits/drawbacks did you experience?

Thank you!

2

Back when I was first diagnosed with depression, I tried St. John’s Wort. Unfortunately, I took it while I was also taking Prozac, which is contra-indicated. It apparently increases the incidence of side effects of Prozac, and I ended up walking around all day feeling like I was about two seconds from projectile vomiting.

However, this is not to say it’s ineffective. The reading I’d done at the time suggested that St. John’s Wort is effective in treating mild to moderate depression and also at improving baseline emotions in most people. Peter McWilliams not only wrote an entire book about it, but because he couldn’t find properly prepared St. John’s Wort extract, he started his own company to make St. John’s Wort pills. Only, he refers to it by it’s Latinate name, Hypericum.

His book for free. You can also follow the links from mcwilliams.com and purchase hypericum pills from his company.

3

[QUOTE=Roboto]
Has anyone tried this, and did you find it helpful? I’m attracted to this idea because it’s a natural herb rather than a manufactured drug.

Last year I tried Lexipro, which had too many side effects, and Remeron, which was helpful but gave me restless leg syndrome. After that, I said to hell with prescription drugs for depression and have been trying to level my moods through diet and exercise. But, that doesn’t always work, and I was thinking about trying something new when I read that St. John’s Wort can be used to treat mild to moderate depression. I thought to myself, “Perfect!”

So, I think I’m going to try it. What were your experiences with St. John’s Wort? What other benefits/drawbacks did you experience?

Thank you!
[/QUOTE]

Anecdotal evidence: I have occasionally suffered from low-level depression, which manifests itself as a surly, snarly attitude. When I was like that, St. John’s Wort made all the difference between being tolerable and chewing my wife’s head off.

The one time it got into full-blown stereotypical depression, StJW had no discernable effect.

The doctor tried to take me off StJW in favor of Celexa, and that turned me into the good Kirk from the split Kirk episode of Star Trek. Like him, I could not function without my dark side.

4

[QUOTE=VunderBob]
When I was like that, St. John’s Wort made all the difference between being tolerable and chewing my wife’s head off.
[/QUOTE]

Did you take it on an “as-needed” basis, or were you talking it regularly? I read I’d need to take it 3x per day for 5 weeks to notice any difference.

5

[QUOTE=Roboto]
Did you take it on an “as-needed” basis, or were you talking it regularly? I read I’d need to take it 3x per day for 5 weeks to notice any difference.
[/QUOTE]

I took it one time daily, in the morning. I don’t remember the dosage, however. It took me about 2 weeks to notice an effect.

6

Awesome . . . thank you!

7

IIRC, St. Johns Wort has a side effect of causing increased photo-sensitivity.

ETA, the stuff did help me with pretty mild depression, but the light sensitive thing is why I stopped taking it.

8

Someone I knew tried this. It didn’t help with depression at all, they claimed. And it had some other side effect (not photosensitivity, I’m pretty sure) that made it not at all a good idea. I don’t recall what it was – I’ll have to ask and see if they can tell me.

9

Yes, St. John’s Wort may cause increased photosensitivity, so those using it should be sure to use sunscreen. It has been shown to be effective at treating mild to moderate depression. One large and oft-quoted study found it not effective at treating severe depression…however that selfsame study* also found the antidepressant sertraline to have no more effect than the placebo, so I suspect problems with the study design or implementation.

There are a few drugs metabolized through the liver that are listed as contraindicated with SJW, indinavir (an HIV drug) being the only one proven. It is suspected that St. John’s Wort is metabolized through something called the cytochrome P450 pathway, and that it may therefore potentate (make too strong) or cause too quick metabolism of some drugs for heart disease, cancer, depression, seizures and viral infections as well as birth control pills, although I am not aware of their being any proven interaction in studies or in the patient population - only in theory. So if you have any of those conditions, it’s best to run things by your doctor first.

As for dosing, I go with half a teaspoon of my own whole plant tincture (1:1, 50%) three times a day. I really highly recommend a whole plant extract rather than a standardized one, especially for this plant. They’ve been dithering for years about whether it’s the hypericin or hyperforin or something else that’s actually the “active” ingredient. Since it’s such a sweet little plant, I just use the whole damn thing (aerial portions, including flowers, not the roots) to be sure - as is the traditional way. But if all you can find is a standardized extract, then look for one with 0.3% hypericin and as much hyperforin as you can get - up to 5%. Take 300mg 3 times a day, and you’ll probably see some effect in about two weeks. If not, keep trying, and if you hit 6 weeks with no result, give it up and try something else.
Funny story: The first time I opened up a shipment of Saint John’s Wort plants, I screamed like a little girl and ran out of the room - it was CRAWLING with little shiny beetles. Sobbing, I called the farm it came from (Saint John’s Wort must be tinctured fresh, not dried, so they pick it and send it out directly, no middleguy) and the woman on the other end of the phone laughed and laughed. She explained that “back in the day”, ranchers discovered that cattle really like to eat Saint John’s Wort. However light colored cattle ran into sunburn problems due to the photosensitivity problem. So they introduced these beetles, which love the Saint John’s Wort plant but leave everything else alone, because apparently a cow is just as startled by shiny beetles as I was - and so they won’t eat the Saint John’s Wort! I have no idea if this is true or just some story told to fool the city girl, but every shipment I get of Saint John’s Wort, from multiple vendors, have had these little beetles in it. They don’t bite or sting, and they haven’t infested my garden, so I just remember to open my boxes of St John’s Wort outside now!
WhyNot,
Herbalist

*Hypericum Depression Trial Study Group (2002). Effect of Hypericum perforatum (St John’s Wort) in Major Depressive Disorder. JAMA 287 (14), 1807-1814. PMID 11939866

10

I’ll try to find the exact cite when I get home but a couple of years ago Skeptical Enquirer did an article about herbal medicines and which ones actually work. There were only two that worked better than a placebo and St. John’s Wort was one of them. As I recall it worked better than a placebo for relieving depression but not as well as the most popular pharmaceutical drugs.

11

[QUOTE=hajario]
I’ll try to find the exact cite when I get home but a couple of years ago Skeptical Enquirer did an article about herbal medicines and which ones actually work. There were only two that worked better than a placebo and St. John’s Wort was one of them. As I recall it worked better than a placebo for relieving depression but not as well as the most popular pharmaceutical drugs.
[/QUOTE]
That’s why is sounds like a good fit for me . . . the pharmeceutical drugs I tried felt like . . . they were messing with my brain, because they were. Lexipro actually made me feel high, which was kind of fun but not what I needed, and the other side effects were too much to tolerate (constantly felt “flush”). Remeron gave me shaky leg sydrome, which is the weirdest feeling in the world. I couldn’t help but kick my leg every 3 minutes or so. Forget that!

I also was prescribed Xanax, which I loved . . . too much. I’d take it when I couldn’t sleep due to anxiety, and it knocked me out and I’d wake up feeling great! But I knew it was addictive and I can see why. I stopped using it because I could see it becoming a crutch . . . like I couldn’t sleep without it. I guess I have an addictive personality, and do have several alcoholics in the family. Glad I didn’t get sucked in to that.

So the herbal route it where I’m headed. Thanks all for your insights, they truly are helpful. I’m going to try it, and if it works, I’ll make sure to let everyone know.

12

[QUOTE=hajario]
I’ll try to find the exact cite when I get home but a couple of years ago Skeptical Enquirer did an article about herbal medicines and which ones actually work. There were only two that worked better than a placebo and St. John’s Wort was one of them. As I recall it worked better than a placebo for relieving depression but not as well as the most popular pharmaceutical drugs.
[/QUOTE]

I recall reading this, too, and it matches precisely my own experience. SJW worked really, really well for me for a time, but after a while was insufficient and ultimately I got better results with prescribed meds.

The other thing you have to be careful about is to get a reliable source, which is not necessarily the least expensive. Since these herbal remedies are not really regulated by anyone, they can and sometimes do have varying amounts of the actual active ingredients, regardless of what’s on the label.

13

I’ve been intending to start this topic for days and was hoping WhyNot would show up as our resident herbalist. Geez I love this place.

WhyNot - so if I wanted to start taking SJW, where should I get it, how should I prepare it, how do I find my dosage, etc.?

Thanks much!

Roboto - yup, me too. The anti-anxiety and anti-depression drugs I’ve tried have caused major side effects and I really don’t want to just keep trying them at random. I’ve heard some scary things about some of them. Xanax works well for me if I get an acute anxiety attack, but I try not to take them too often.

14

[QUOTE=redtail23]

WhyNot - so if I wanted to start taking SJW, where should I get it, how should I prepare it, how do I find my dosage, etc.?
[/QUOTE]
I’m open to those suggestions as well . . . I’m going to the pharmacy tonight and will get whatever looks most reasonable based on what I’m learning here.

[QUOTE=redtail23]
Roboto - yup, me too. The anti-anxiety and anti-depression drugs I’ve tried have caused major side effects and I really don’t want to just keep trying them at random. I’ve heard some scary things about some of them. Xanax works well for me if I get an acute anxiety attack, but I try not to take them too often.
[/QUOTE]
I’d be happy to share with you what I end up getting, which will likely be tonight. If you’d like, we can compare notes. I’m stoked about the “2 week” timeframe as well, so hopefully I’ll be able to tell a difference before too long.

15

[QUOTE=redtail23]

WhyNot - so if I wanted to start taking SJW, where should I get it, how should I prepare it, how do I find my dosage, etc.?
[/QUOTE]

Well, my first suggestion involves a time machine and a bottle of vodka. Just set your time machine back to about June 24, 2007 (the year is really irrelevant, perhaps you’d prefer a nice midsummer day in 1873?) and find a field of Saint John’s Wort in flower growing away (at least 100 feet away) from any roads or obvious pollution. Get the owner’s permission before harvesting! Cut the St. John’s Wort off about a third of the way down the stem, and cut the plants into inch long pieces into a large jar that’s sitting on a scale you’ve tared to zero. Gallon sized jars work best. Mind the beetles.

When you’ve got as much SJW as you feel like harvesting, look at your scale and see how much you’ve got. For every ounce (weight) of SJW, you’re going to pour in one ounce (liquid measure) of 100 proof alcohol. Cheap vodka is best. If you can’t find 100 proof, you’ll have to do math and stuff to make your liquid equal 50% alcohol. If your liquid doesn’t cover the herb, you’ll have to chop it finer - a pair of scissors lowered into the liquid usually does the trick. Write a label with todays date, where you harvested the herb, what sort of alcohol you used and how much, and, of course, what the herb is. You think you’ll remember. You won’t.

Now take that home with you, stick it in a dark room and give it a good shake every day. In about 4 weeks (make sure you include one full moon cycle if you’re into the woo), you can press your tincture. Line a colander sitting in a big bowl with cheesecloth and spoon the contents of the jar in. With one hand, lift the colander so the liquid can drain, with another, gather the ends of the cheesecloth together, and twist to squeeze out as much liquid as you can. Make a mental note to buy an herb press if you ever do this again.

Jar up the liquid - cleaned and disinfected Grolsch bottles are excellent for this - and write some labels which include all the information from your tincturing label plus today’s date (so you know how long it tinctured for). Take 1/2 tsp of this liquid 3 times a day.

Okay, you’re probably not going to do all that. I get it. I’m loathe to endorse any particular vendors, simply ‘cause I’m not a shill. I don’t work with these folks, but here are a few names I trust - these are the folks *I’ll *buy from if my own stash runs out: Eclectic Institute, Laughing Ladybug (their process is slightly different then what I outlined above, involving further steps to purify and potentiate their products so you only need a few drops instead of 1/2 a teaspoon. Amazing stuff which I don’t really understand. Full disclosure: the owner is a friend of mine.) Herbalist and Alchemist (Full disclosure: the owner is a dick, but he knows his herbs.) Some of these are available in stores and herbalists’ shops, and some over the internet. Good luck!

ETA: Oh, right! Dosage. Check the product you buy because they might vary (like Laughing Ladybug’s - 4 drops is a lot different than half a teaspoon!) Generally I’ve found anything under 900 mg a day of capsules to be a waste of herbs. You can divide that into three doses per day, if you like. If you’ve reached the four week mark with no impact, then you can go half again as much - up to 1500 mg or 2 1/2 tsps of tincture a day with no problem. Much more than that, and chances are there’s something out there that will work better for you.

16

Just chiming in to add that St. John’s Wort is one of those things that you must discontinue two weeks before any scheduled surgery. It’s also something that you should list any time a medical person asks what medications you’re taking.

17

CNN just ran an article yesterday, titled, "5 alternative medicine treatments that work, and one of them was St. John’s Wort.

Anecdotally, I can add my voice to the choir that it made a huge difference for me when I went through a bout of moderate depression several years ago. Since it’s an herb, and (other than the aforementioned drug interactions) can’t hurt you, there’s no reason not to give it a try and see how it makes you feel. Good luck!

18

Saint John’s Wort has been a lifesaver for the Superhero. Clinical depression runs in his family, and a few years ago he became seriously depressed. Diet and exercise went a way toward helping, but it wasn’t enough, so he got put on Celexa. It made him feel like his emotions were flat all the time and he really disliked the feeling; plus, there were some sexual side effects that did a whopper on our sex life (he was able to start but not finish. Ahem.)

He went off the Celexa and decided to try SJW about 2 years ago. Since then, he feels like “his old self” (ie, before the depression) and he takes it regularly along with controlling his diet and exercising on a daily basis. It’s wonderful to live with him now. He doesn’t like the way it smells, but he says the benefits are worth it. The few times he’s been without it for more than a few days he can feel a difference in his moods and I see a difference in his behavior (both negative), so it’s definitely having a positive effect.

19

**mLerose ** . . . what brand does your SO/husband take? Does he buy it at the pharmacy or online? I really appreciate the earlier suggestions of some herb shops or online, but I’d prefer to just get it at Rite Aid since it’s easier for me. Thank you!

20

A Doper on sabbatical just PMed me to request that I add the theory that SJW is, or acts like, an MAOI inhibitor to this thread. While I’m not convinced at all that SJW is an MAOI inhibitor, it’s probably worth a mention anyway, so y’all can do your own research and make your own informed opinions.

The most popular and vocal proponent of the MAOI theory was Dr. James Duke, in his book The Green Pharmacy, published in 1997. He includes advice to check with your doctor about foods and drugs which should be avoided while using SJW, the same foods and drugs to be avoided with MAOI’s. I don’t have his cite in electronic form, but I believe it’s on page 6 of his book.

OTOH, Henriette Kress, another highly respected herbalist, claims that this theory is out of date, and has cites to back her up:

So, y’all are going to have to decide on this one for yourselves. I have presented the dispute…choose your sides as you wish.