St John’s Wort (Hypericum perforatum) is a flowering plant that grows throughout much of the World including Europe, North America and parts of Asia. St John’s Wort is of interest nutritionally and medicinally because evidence suggests that it possesses a number of health effects including the possible relief of premenstrual tension and treatment of obsessive compulsive disorder. However St John’s Wort is perhaps best known for its role as an antidepressant in humans. In Germany, St John’s Wort is approved for use in the treatment of mild depression, and there it has obtained an exploratory safety record. The reason for the beneficial effects of St John’s wort on depression are not fully understood, but a number of possible active compounds have been identified. Of these hypericin and hyperforin are perhaps the most likely reason for the antidepressant effects, although a number of other compounds including flavonoids, flavonoid derivatives and volatile oils may contribute to this effect.
St John’s wort may be an effective antidepressant for those with mild to moderate depression. For severe depression, St John’s wort is not an effective treatment, but then no drugs show great efficacy either.
A number of studies have investigated the effectiveness of St John’s Wort on depression and many of these studies have compared St John’s Wort to either a placebo, or to a pharmaceutical medication. In older studies it was shown that St John’s Wort was more effective than a placebo, and as or more effective than some pharmaceutical preparations, particularly the older ones such as the tricyclic antidepressants in the treatment of mild to moderate depression. In more recent reviews of the antidepressant effects of St John’s Wort, research has showed that the herb is more effective than a placebo and some antidepressant medications including amitriptyline, fluoxetine, imipramine and sertraline in the treatment of mild to moderate depression. Studies investigating the effects of St John’s Wort in the treatment of severe depression have been inconsistent. However, many mainstream medications also fail to effectively treat severe depression, often with placebo treatments scoring as highly as medication in these sorts of trials.
Concluding Comments: St John’s Wort appears to be a safe and effective treatment for mild to moderate depression, but may not be suitable for the treatment for more severe depression. In cases of mild to moderate depression, St John’s Wort may be more favourable that mainstream medications due to the fewer side effects that tend to arise from its use. However, treating depression should be seen as a holistic event, and in this respect a number of nutritional and non-nutritional strategies should be followed. Working with a suitable nutritionist, exercise therapist and psychologist in this respect is highly advisable. Educating yourself in these skills can be a highly useful life strategy.
RdB
