Tuesday, April 15, 2014

St. John’s Wort: An Herbal Remedy for Milder Forms of Depression

Depression


depression St. John’s Wort
Although Major Depressive Disorder can be very severe and debilitating, there are also milder forms of depression. “Dysthymia” is a disorder related to depression, but with a milder degree of emotional disturbance; “minor depressive disorder” is another label sometimes used for individuals whose depression is to a less extreme extent, or who meet some but not all of the criteria for being diagnosed with Major Depressive Disorder. Clinical depression is usually treated with a combination of psychotherapy and antidepressant medications. Although antidepressants can be quite effective for treating the symptoms of depression, they also have a range of potentially negative side-effects. For less intense cases of depression, some evidence suggests that St. John’s Wort may be effective in lieu of prescription antidepressants like Zoloft or Lexapro. 

What is St. John’s Wort? 

St. John’s Wort, also known as Hypericum perforatum, is a flowering plant native to Europe. Historically, it has been used as a medicinal herb. Modern research supports the hypothesis that St. John’s Wort may be quite effective for depression. In some studies, it has been shown not only to be superior to a placebo, but to be equally as effective as standard SSRIs like Zoloft. Like SSRIs, which work by inhibiting reuptake of the neurotransmitter serotonin, St. John’s Wort is thought to have its effects by inhibiting serotonin reuptake. Reuptake inhibition increases the available amount of serotonin, a neurotransmitter used in communication between brain cells that is strongly involved in processes involving mood regulation. 

What Makes St. John’s Wort Effective for Depression? 

St. John’s Wort contains numerous chemical compounds. There are two main chemicals that are thought to be tied to the herb’s effect on mood regulation.
·         Hyperforin is a chemical that acts as a reuptake inhibitor for a class of neuro-chemically important compounds called “monoamines”, including serotonin, norepinephrine, dopamine, GABA, and glutamate.
·         Hypericin is another active component found in St. Jon’s Wort that is implicated in its efficacy for treating depression. Along with hyperforin, it helps to give the plant effects similar to MAOI inhibitors, an older form of antidepressant medication.
  

Are Any Risks and Side Effects Associated with St. John’s Wort? 

St. John’s Wort has relatively few side effects, although you should always consult with your physician before beginning any medicine, herb, or supplement. Studies have found it to be less problematic than commercial SSRIs such as Zoloft and Prozac in terms of negative side effects, although the following effects can occur when taking St. John’s Wort:

·         Difficulty sleeping
·         Unusually vivid dreams
·         Stomach upset
·         Fatigue
·         Skin rash
·         Heightened sensitivity to light

Although it has fewer side effects than most depression medications, chemicals contained in St. John’s Wort can interact with other drugs. You should NOT take St. John’s Wort if you are taking one of the following medications:

·         Alprazolam (Xanax). St. John’s Wort can cause the body to excrete the active components of Xanax more quickly, possibly decreasing its effectiveness.
·         Aminolevulinic acid. Both this medicine and St. John’s Wort can increase your sensitivity to sunlight and increase your risk of sunburn.
·         Amitryptaline (Elavil). As with Xanax, St. John’s Wort can cause the body to break this medicine down more quickly, decreasing its effectiveness.
·         Birth control pills. These pills usually contain estrogen; St. John’s Wort can make the body break the estrogen down more quickly.
·         Cyclosporine may have reduced effectiveness when combined with St. John’s Wort.
·         Digoxin may be less effective with St. John’s Wort.
·         Fenfluramine works on serotonin, so if it is taken with St. John’s Wort it can cause there to be too much serotonin, which causes anxiety and nausea.
·         Many antidepressants, especially SSRIs like Celexa, Zoloft, Prozac, and Lexapro, should not be combined with St John’s Wort, in order to avoid too much serotonin.

This is only a partial list of drugs that St. John’s Wort can interact with. If you are considering trying Saint John’s Wort for mild to moderate depression, you should talk to your doctor beforehand to assess the risks of interactions with other medications.


St. John’s Wort is very safe overall, and produces few side effects. Clinical studies have indicated that for mild to moderate depression, it may be as effective as many antidepressants--- without the negative side effects. 

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