As the majority of people in this world, I suffer from mild depression from time to time. Although this has never been serious enough to cause any changes in my ability to function, it is enough of an interference in my life to cause me to seek some sort of therapy. Most of the time a good healthy cry or some exercise will take care of any mild depression but there are times when more is needed. Many people in this sort of situation are reluctant to try any sort of "personality altering" drug such as Prozac. There is little doubt that these drugs do wonders for people with cases of severe depression but they are a little extreme for the minor depression found in most everyday life. A natural alternative to these synthetic drugs seems greatly appealing to me. Many vitamin and pharmaceutical companies are now offering such a drug: St John's Wort.
This natural "mood-enhancer", also known as hypericum, is now being displayed all over television, the radio, and the Internet. It can be found everywhere: in the local health food store, grocery stores, across the Internet, and in some countries, the doctor's office(1) (2). But what is it? Is it really safe? How much is actually known about the effects of this "wonder cure"? The answers to these questions are not as easily answered as one might think. Although the Internet is a strong source of information it is very cluttered with advertisement sites for this drug providing little or no information besides its benefits and praises (3). Also, this drug has not yet been approved by the FDA in the United States and therefore is not prescribed. Following FDA approval, more will be known about the drug and its effects.
There is little doubt that this drug does wonders for mild depression. In 1996 research in England showed that hypericum not only worked better than the placebo but in many cases worked just as well as the tested prescription drugs (4). The National Health Institute is currently in the middle of a three-year research project concerning hypericum that should end in the year 2000. FDA approval should be following shortly thereafter. In Germany, however, hypericum is a licensed drug that is prescribed twice as often as standard antidepressants (1). Almost 200,000 prescriptions are filled every month for Jarsin, a drug containing hypericum (5).
The known information about St John's Wort comes from historical and botanical information, studies in many foreign counties, and preliminary studies in the United States. This yellow wildflower, considered a pest in some parts of the world due to its photosynthetic properties, is a member of the genus hypericum (6). Herbalists such as Dioscorrides and Theophrastus have used it since ancient Greek times to treat everything from burns and fevers to witches and demons. It has also commonly been used to treat neurological illnesses such as hysteria, depression, and even by some societies, insanity. Today's busy and overworked society, however, is primarily concerned with this herbs ability to treat depression. Because depression affects so many people and has such a high suicide rate associated with it, its diagnosis and subsequent treatment has become the focus of much debate and exploration.
The diagnosis of depression is oftentimes more difficult than the treatment. The symptoms are very subjective and range from despondency to changes in daily life patterns (5). It can be caused by anything from side effects of a medication to hormones or even physical illness. Also when diagnosing, a doctor must decide to what severity the patient is depressed (mild, moderate, severe). Treatment may be different depending on all of these factors. Prescription drugs, such as Prozac, or electroconvulsive therapy are prescribed for the most severe cases. But these treatments tend to be a little extreme and somewhat invasive. The mild cases are generally relieved with treatments such as psychotherapy, exercise, mind/body medicine, nutrition, and diet (7).
The current theory regarding hypericum results from many trials and lots of research, mainly in Europe. It is now thought that St John's Wort increases the amount of serotonin and possibly other neurotransmitters such as dopamine and norepinephrine. It does this by means of MAO (monoamine oxidase) inhibition. It is also thought to inhibit COMT (catechol-O-methyltransferase) (5). Both of these enzymes destroy amines such as serotonin, epinephrine, and dopamine, which are believed to be what causes one to "feel good". By blocking these harmful enzymes, the drug allows the body to feel the continued effect of the amines. In this way, St John's Wort is much like Prozac and other prescription drugs. But the side effects are much less extreme.
Although there are side effects to St John's Wort none are so drastic as those found in other, synthetic drugs. Prozac can cause serious effects such as insomnia, weight loss, and sexual dysfunction (1). But the most severe reported side effects of hypericum include only restlessness, gastrointestinal irritations, hypersensitivity to sunlight, dry mouth, dizziness, and fatigue. These effects are found in less than 2.5 percent of depressed patients (1) (8).
Dr Nierenberg, associate director of the clinical and research program in depression at Massachusetts General Hospital, is concerned not about the effects of the dug, but rather the risks of self-treatment. He stresses the fact that depression is not a condition to be taken lightly and fears that people will try the drug without consulting a doctor (4). In some cases doctor intervention is absolutely necessary. It could be very dangerous for someone with severe depression to experiment with St Johns Wort when other medications may be more effective and more complete. Should you try it? I occasionally take St John's Wort during periods of high stress in my life that I know sometimes lead to depression. The decision to try hypericum, or any other drug, should only come after a thorough evaluation by a physician and an extensive understanding of the drug and its side effects.
2)Prozac, Move Over,
3)St John's Wort,
4)Should You Take St John's Wort?,
5)Herbal Remedies- St John's Wort,
6)St John's Wort: a Review,
8)St John's Wort,
| Course Home Page
| Back to Brain and Behavior
| Back to Serendip |
This paper reflects the research and thoughts of a student at the time the paper was written for a course at Bryn Mawr College. Like other materials on Serendip, it is not intended to be "authoritative" but rather to help others further develop their own explorations. Web links were active as of the time the paper was posted but are not updated.