St. John's Wort: Depression & Anxiety

St. John's Wort vs. Prescription Drugs

Why choose St. John’s Wort over prescription drugs?
Users of herbal supplements have long recognized the therapeutic benefits of taking St. John’s Wort to alleviate the symptoms of depression and anxiety. According to a recently completed study (2005) published in the British Medical Journal, about 57% of the 251 participants stated that their symptoms of moderate-to-severe depression decreased with 900 mg/day hyperforin-rich Hypericum (St Johns Wort) extract, while only 45% in the group taking paroxetine (Paxil®) had reduced symptoms.1 Another study published in October 2005 compared hyperforin-rich Hypericum extract to fluoxetine (Prozac®) and placebo. This trial found that participants who took Hypericum experienced a 48% greater reduction in symptoms of depression than those taking fluoxetine by the end of 12 weeks.2

Effective and Gentle
Although individual experiences vary, St. John's Wort generally does not make users feel sedated, drugged, numb, or emotionally "flat". Unlike SSRI antidepressant drugs, St. John's Wort does not cause withdrawal symptoms when stopped. Also, St Johns Wort may be safely taken by teens (with parental and medical supervision, of course).3,4 While an increased risk of suicide in teenagers is associated with many SSRI medications, there is no evidence that St. John's Wort poses a similar risk.

Fewer side effects
Independently published clinical research has established that St. John’s Wort often works as well as prescription antidepressants. And yet in many of these same studies St. John's Wort caused significantly fewer side effects than the drugs. Many popular SSRI antidepressants can cause side effects such as sexual dysfunction and weight gain, both of which are not typically associated with St. John's Wort. In fact, most users of St. John’s Wort do not experience any side effects. A German study5 published in Pharmacopsychiatry compared Hypericum extract (500mg/day) with fluoxetine (Prozac® 20mg/day) in a randomized, double-blind multicenter trial including 240 patients. "Adverse events occurred in 28 patients (25%) in the fluoxetine group and in 18 (14%) of the St. John's wort group... St. John's wort revealed better safety and tolerability data than fluoxetine."

A small number of users may experience side effects that are usually mild and transient compared to drugs. Some possible side effects include mild headache or fatigue, although these often diminish after a few weeks. One rare but potentially problematic side effect is increased sensitivity to sunlight.

Completely Natural
St. John’s Wort preparations are derived from the Hypericum perforatum plant. Most products are dried extracts in powder form, although St. John's Wort may also be prepared as an oil extract, infusion, tincture, or salve depending upon the use and method of delivery. In all cases, St. John's Wort products are 100% natural and do not contain synthetic chemicals. (Keep in mind, however, that natural does not always mean better or completely safe. Some plants are poisonous despite being 100% natural. Fortunately, St Johns Wort is very safe!)

1 Szegedi A, Kohnen R, Dienel A, Kieser M. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine. British Medical Journal 2005 Feb.
2 Fava M, Alpert J, Nierenberg AA, Mischoulon D, et al. A double-blind, randomized trial of St. John's wort, fluoxetine, and placebo in major depressive disorder. J Clin Psychopharmacol 2005 Oct;25(5):441-7.
3 Günter Seelinger, Marcus Mannel. Drug Treatment in Juvenile Depression? Is St. John's Wort a Safe and Effective Alternative?J Child and Adolescent Mental Health 2007 Oct; 12(3): 143-149.
4 Jörg M. Fegert, M. Kölch, Julie Magno Zito, Gerd Glaeske, Katrin Janhsen. Antidepressant Use in Children and Adolescents in Germany.Journal of Child and Adolescent Psychopharmacology. 2006, 16(1-2): 197-206. doi:10.1089/cap.2006.16.197.
5 Friede M, Henneicke von Zepelin HH, Freudenstein J. Differential therapy of mild to moderate depressive episodes (ICD-10 F 32.0; F 32.1) with St. John's wort. Pharmacopsychiatry 2001 Jul:34 Suppl 1:S38-41.
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