Depression
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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