Dear dopers!
I am looking to start taking St John’s Wort as a potential treatment for my depression. Uncle google says there is evidence it works. Any dopers who have taken / are taking this herb please weigh in with your experiences! It will help me be aware and avoid pitfalls.
(I had been prescribed a vast array of medications over the years - but I am glad to report I titrated myself off those and am still sane (though no happier than before). Now seeking the herbal route to happiness.)
Be aware that St. John’s Wort has an array of interactions with other drugs, some of them potentially life-threatening. So I’m happy to hear that right now you’re off other medications. Just be aware of this, and be sure that if someone does prescribe medicine for you that you inform the doctor that you are taking StJW.
Otherwise, good luck, I hope it helps you.
Thank you. I am off SSRIs now; only a small dose of haloperidol. If you have used SJW, did it work for you? In particular, did it affect your sleep cycle in any way?
didn’t really feel like it did anything for me. but since “dietary supplements” are pretty much unregulated, who knows if what I was taking was what it was supposed to be.
It’s really doubtful that “the herbal route to happiness” is going to be a better bet.
While there’s reasonably good evidence SJW can work about as well as typical antidepressant meds on mild to moderate depression, it doesn’t seem to be better at relieving symptoms, plus (as noted earlier) there’s a problem with lack of standardization and reliability of over-the-counter SJW supplements.
“Patients suffering from depressive symptoms who wish to use a St. John’s wort product should consult a health professional. Using a St. John’s wort extract might be justified, but important issues should be taken into account: St. John’s wort products available on the market vary to a great extent.”
St. John's wort for treating depression. | Cochrane.
SJW is another antidepressant drug, wearing the cloak of a “natural” remedy.
to be fair, willow tree bark once was a natural remedy, then once it was discovered why it worked it became medicine.
I tried it back when, no real results. Talked to doctors and looked at studies and it’s just one of those things that might work for some people but there’s no consistent results. Already mentioned is the problem of consistent content in the pills you can buy, and one study noted a higher than expected placebo effect. I guess it can’t hurt to try if you understand the potential interactions with other drugs. For any one person it might do the trick, and it might have fewer associated problems than other anti-depressant medications, and none of them are ideal anyway.
My depression was too severe for SJW.
I did not work for me.
SSRIs seem to be necessary for me.
Not the best of comparisons. Salicylic acid (the main active component in willow bark for pain relief) was used for awhile, but proved problematic because of serious side effects (i.e. on the gastrointestinal tract). Willow bark itself was (and is) prone to markedly inconsistent results due to problems of standardization and purity.
There are still people who think willow bark is a superior pain remedy, overlooking the fact that preparations are bound to be highly variable in content and efficacy. It’s the “natural must be safer and better” fallacy. It took the the development of acetylsalicylic acid (aspirin) for truly effective and safer pain relief to be achieved.
As for SJW, this article details some of the potential benefits and problems with its use.
“As is the case with many dietary herbal supplements, the amount of active ingredients may vary significantly depending on the source, time of the year of the harvest, plant component used, and the type of preparation. For example, one study analyzed the total naphthodianthrone content of 54 commercially available preparations of St. John’s wort. The measured amounts varied considerably from those claimed on the labels, from 0% to 109% for capsules and from 31% to 80% for tablets.[2] Another group reported that, whereas the amounts of pseudohypericin among 30 plants did not vary significantly, the concentrations of hyperforin did vary significantly. Such variability has significant implications for potential herbal-drug interactions and efficacy, as noted below…
St. John’s wort has gained considerable popularity as a dietary herbal supplement for the treatment of depression. There have been numerous trials using standardized St. John’s wort extracts. Results were variable, probably due to the heterogeneity of the presumed active components and lack of double-blind placebo-controlled trials. However, several statistically significant observations have emerged from meta-analyses of these trials. For mild-to-moderate depressive disorders, it appears that St. John’s wort may be as effective as SSRIs and more efficacious than placebos. However, it has not been found to be uniformly effective in major depressive disorders. With the exception of its effects on drug transport and metabolism, St. John’s wort appears to have relatively few side effects. Although the incidence is low, the most common side effects of St. John’s wort appear to be headache, dry mouth, nausea, gastrointestinal upset and sleepiness. A rare side effect reported for St. John’s wort is photosensitivity.
Words of Caution
Because of its availability as an herbal supplement, many individuals are taking St. John’s wort without consulting or informing their physicians or pharmacists. This is problematic because of the potential for an herbal-drug interaction. Most notably, taking St John’s wort could lead to a loss of efficacy of a prescription drug because of the induction of one or more drug metabolizing enzymes ( Table 1 ). Because of the variable content of its components, taking St. John’s wort could also lead to changes in efficacy or potential toxicity, depending on when the pharmaceutical was started and how many different preparations of St. John’s wort were consumed. Another potential concern is for those patients taking SSRIs who decide to add St. John’s wort to their therapeutic regimen. They are at increased risk of experiencing the serotonin syndrome, a potentially serious adverse event which may be manifested by symptoms of lack of coordination, hyperreflexia, agitation, coma, confusion, tremor, fever, nausea and diarrhea ( Table 2 ). Patients often believe that if a drug is “natural” then it is safe. This is simply not true, and patients must be cautioned about the potential risks if they choose to treat their depression with St. John’s wort.”
You are essentially contemplating taking random doses of medication.
Among other things, it can inactivate birth control pills.
I would not recommend using it if you’re on ANY other prescription medication.
St John’s Wort is regarded as a medicine in Germany, but right now the verdict is not definite, German studies indicated it was equal to antidepressants, but studies outside of Germany did not replicate the results, which left one to question, why is it able to be replicated inside of Germany but not outside of.
One thing St John’s Wort has going for it is that it is well tolerated. Few people stop taking it because of side effects, this is not so with antidepressants.
Another thing to consider is any antidepressant doesn’t always work for everyone. When I was studying to be a psychologist, I went through clinicals and found people that did fine on say, Zoloft but had not results with Paxil and so on.
So if similar structured antidepressants can result in varied responses that is something to consider.
It has been contraindicated in those with bipolar and schizophrenia, having it’s main areas being studied are depression.
I’ve also heard of Lithium orotate being touted as helpful for depression and it’s sold over the counter. It’s different from the prescribed form of lithium and has barely any research and the things I’ve read, lead me to believe it’s has a very effective placebo effect.
It’s banned in this nanny-state called the Republic of Ireland. That’s all I know :mad:
Given that fact, it must have effective results seeing as any type of herbal medicine that does gets banned here.
Must be that dreaded Big Gaelic Pharma. :eek:
To be even fairer, that’s a on the border of myth and reality. Modern aspirin has very little in common, and is stunningly more effective, than willow bark, although willow was part of the inspiration for it.
Barbarian’s comment is well worth remembering whenever dealing with “natural” medications: Either they’re not pharmacologically active, in which case they’re useless and you’re just seeing placebo effects, or they have actual medical effects, in which case you’re taking unregulated, largely unmeasured, and unstudied doses of things that are affecting your body in unknown ways.
Willow bark contains a host of different compounds, some of which are possibly pharmacologically active and are speculated to work on different aspects of human physiology. There are willow bark adherents who believe all of these effects must be beneficial and make it superior to aspirin.
This typifies the “whole herb” philosophy, which holds that nature’s remedies are designed to be effective based on the confluence of all these chemical compounds, while man’s extraction of active principles is flawed. Rather than accept that plant compounds evolved to benefit the plant, it is believed that they were designed to benefit mankind.
This farcially human-centric attitude depends on there being a creator who arranged plants (and animals) for our enjoyment and profit.
The world is our oyster!!
Uh-oh, vibrio! 
Why are you referring to us as dopers?
Speak for yourself, please. I do not engage in illegal drugs.
I can tell you, though, that the individual results for St. John’s Wort or wildly varied. So much so, in fact, to make any discussion of the topic, and any answer we could give about our own experience, all but meaningless.
I CAN tell you that, as a physical therapist who very often has clients who have been prescscirbed anti=depressant meds for their pain–that is, as an analgesic–I have heard very few positive things about SJW. I have heard more negative than positive. And I am inlcuding, among the negative, the “it didnt do a thing for me.” Which is a very common claim, btw.
Consult with your doc. The causes of depression are also varied. And you need to make sure yours is of the clinical and chronic or acute type where and anti-depressant is gonna be required and then even helpful. Most likely a doc in the US is gonna pooh-pooh SJW and instead suggest an SSRI to begin with.
Best of luck to you.
If you post as a member or guest of the Straight Dope Message Board, you are automatically a ‘doper’, in the spirit of providing the “straight dope” or unvarnished truth.
QtM, purveyer of the “straight dope” on a wide variety of topics, along with a wide variety of prescription pharmaceuticals. The former is distributed far and wide to the teeming millions, the latter is only by legitimate prescription to my very own patients for necessary medical care.
P.S. Avoid St. John’s Wort, not enough info about its safety and effectiveness.
Ahhhhh!!
Thanks for the heads-up on the lingo around here. My bad.
Cheers.