St John's Wort for Depression

There is now solid scientific evidence that St John's Wort is effective for mild to moderate depression. In fact, it's just as effective as tricyclic anti-depressants (drugs like amitriptyline and amoxapine).

But just because it's natural and available over the counter at your local health food store, doesn't mean you should throw your bottle of Elavil in the trash and start popping St Johns Wort instead!

Remember, even natural remedies have side effects and precautions that you need to take into account. And like any therapy, it won't work if you take the wrong dosage or don't take the full course of treatment.

If you're taking any other drugs, be careful! St Johns Wort is very good at removing toxins from the body - it will very effectively purge anything that doesn't belong in your system.

Unfortunately, if you're taking prescription drugs for any condition, that medication doesn't naturally belong in your body, and St John's Wort will treat it like a toxin. That means it will flush the drug right out of your system - so it will have less effect than normal, or even no effect at all.

Don't take St John's Wort if you're taking any of the following:

• Anticoagulants
• Birth control pills
• Blood pressure medications
  
• Cyclosporine (anti-rejection drug for organ transplants)
  
• Digoxin (heart medication)
  
• Epilepsy medication
• Protease inhibitors for HIV
  
• Irinotecan

In fact, if you're taking any other kind of regular medication, it's best to check with your doctor before taking Saint John's Wort, to be on the safe side. Like most supplements, it's not recommended if you're pregnant or nursing.

Never take St John's Wort and a prescribed anti-depressant at the same time.

One reason is the same as the other drug interactions - St John's Wort may flush the other drug out of your system, so you may as well not swallow it in the first place.

However, if the St Johns doesn't flush out the other drug, you may end up with too much serotonin in your system, which can lead to nasty side-effects.

So, if you want to try St Johns Wort for your depression, you need to wean yourself of your anti-depressant pills first - and you should definitely get your doctor's advice before trying that.

The medicinal compounds found in Hypericum Perforatum (St Johns Wort) are:

• Ad-hyperforin
• Dianthrone
• Hyperforin
• Hypericin
• Xanthones
• Flavonoids

It used to be thought the Hyperforin was the only important ingredient in St John's Wort, so you may see Hypericum capsules described as "Hyperforin extract" or "standardised to x % hyperforin".

However, natural therapies are rarely as simple as that! Time and again, scientists try to isolate the "magic ingredient", only to find there isn't one, and it's the combination of compounds in the plant that has the effect. So it is with Hypericum. So don't worry too much about whether a product is standardized, and avoid anything called an "extract": instead, stick to the general St John's Wort or Hypericum products. Or make your own tincture from your own fresh plants!

If you're buying a capsule, aim for around 900 mg a day (usually 300mg, three times a day). Be patient - it takes four to six weeks to see the effects.

A recent trial showed that while St John's Wort is very helpful for mild depression, it simply doesn't work for major depression. If you're deeply depressed, don't lose time by playing around with St John's Wort or other natural alternatives - you need professional help, please don't hesitate to seek it out.

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All text copyright Marisa Wright. St John's Wort flower photo by Crabchick.