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Antidepressants > St. John's Wort
St. John's Wort (Hypericum perforatum)
Related Topics:
Specific Recommendations:
Ze 117 Extract (Not available in the
US, Remotiv brand in Germany):
- St. John's Wort Equivalent to World's Best-selling Antidepressant
- herbs.org
- No one can argue placebo effect on this study:
St. John's wort extract Ze 117 (Hypericum perforatum) inhibits
norepinephrine and serotonin uptake into rat brain slices and reduces
3-adrenoceptor numbers on cultured rat brain cells - Pharmacopsychiatry
2001 Jul;34 Suppl 1:S56-60 -
"The Ze 117 extract was more selective for the uptake of NE than for that of
5-HT. The maximal extent of uptake inhibition by Ze 117 extract was
comparable to that of imipramine (IMI), desipramine (DMI) or fluvoxamine for
5-HT, but lower for NE transport, than that of the synthetic
antidepressants"
-
Equivalence of St John's wort extract (Ze 117) and fluoxetine: a randomized,
controlled study in mild-moderate depression - Int
Clin Psychopharmacol 2000 Mar;15(2):61-8 -
"We concluded that hypericum and fluoxetine are equipotent with respect to
all main parameters used to investigate antidepressants in this population.
Although hypericum may be superior in improving the responder rate, the main
difference between the two treatments is safety. Hypericum was superior to
fluoxetine in overall incidence of side-effects, number of patients with
side-effects and the type of side-effect reported"
-
Comparison of St John's wort and imipramine for treating depression:
randomised controlled trial - BMJ 2000 Sep
2;321(7260):536-9 -
"Among the 157 participants taking
hypericum mean scores on the Hamilton depression scale decreased from 22.4
at baseline to 12.00 at end point; among the 167 participants taking imipramine they fell from 22.1 to 12.75 ... This Hypericum perforatum
extract is therapeutically equivalent to imipramine in treating mild to
moderate depression, but patients tolerate hypericum better" - Bottom
line, the SJW group rated more depressed than the imipramine group before
the study and less depressed than the imipramine group after the study.
There are doctor's who would argue that they should have used 225 mg of
imipramine but then they could have tried 750 mg on the Ze 117 extract
also.- Ben
- Comparison of St. John's Wort and Imipramine for Treating Depression:
Randomised Controlled Trial - Medscape, 9/00
-
Comparison of St John's wort and imipramine for treating depression:
randomised controlled trial - BMJ 2000 Sep 2;321(7260):536-9
- St. John's Wort Trumps Depression Drug - WebMD,
9/1/00
- Comparison of St John's wort and imipramine for treating depression:
randomised controlled trial - BMJ 2000;321:536539
(2 September) - "Among the 157
participants taking hypericum mean scores on the Hamilton depression scale
decreased from 22.4 at baseline to 12.00 at end point; among the 167
participants taking imipramine they fell from 22.1 to 12.75"
-
Medline search of Ze 117
LI 160 Extract (Kira®
Brand LI-160 extract in the US, Jarsin 300
brand in Germany):
-
Medicinal Plant, St John's Wort, May Reduce Neuronal Degeneration Caused By
Parkinson's Disease - Science Daily, 5/11/09 -
"suggests that this plant with antidepressant properties has antioxidant
active ingredients that could help reduce the neuronal degeneration caused
by the disease" - See
Kira® (LI 160 extract) St. John's wort at iHerb.
- St. John's Wort Useful for Severe Depression -
WebMD, 2/10/05 -
"At the end of six weeks, 71% of the patients taking St. John's Wort and 60%
of those taking Paxil had responded to treatment. Half of the St. John's
Wort-treated patients and 35% of the Paxil-treated patients were free of
depression symptoms"
- New Use Suggested For St. John's Wort -
Psychiatric News, 9/17/04 - "St.
John's wort "may be a useful therapeutic alternative in the acute treatment
of mildly to moderately severe
somatoform disorder." ... The St. John's wort used in this study is from
a specific company, Lichtwer, with a long history of outstanding quality
control and a consistent approach to the processing of St. John's wort.
Individuals going to health food stores and purchasing St. John's wort are
not likely to find the same consistency in the quality of the product"
- Lichtwer is the LI-160 extract sold under the band name
Kira®
in the U.S.
- St.
John's Wort as Effective as Zoloft® against Depression
- New Hope Natural Media Online, 6/13/02 -
"St. John's wort (SJW), a popular herbal remedy, is at least as effective as
the prescription drug sertraline
(Zoloft®) in the treatment of depression
and causes fewer side effects, according to a new study published in
Canadian Family Physician (2002;48:905–8). This report confirms dozens of
other studies demonstrating SJW is an effective treatment for
mild-to-moderate depression, and contradicts two controversial studies
suggesting the herb is of little or no benefit ... After 12 weeks, the
severity of depression had decreased by an average of 50.2% in the SJW group
and by 41.6% in the sertraline group"
-
Effect of Hypericum perforatum (St John's Wort) in Major Depressive
Disorder: A Randomized Controlled Trial - JAMA, 4/10/02 -
"extract (LI-160) ... neither sertraline nor H perforatum
was significantly different from placebo ... Dr Davidson holds stock in
Pfizer"
- Money colors drug research - USA Today,
1/22/03 -
"industry funding makes it 3.6 times more likely that a study result
will be favorable to the sponsor"
- St. John's Wort Not Effective -- Again - WebMD,
4/9/02
-
Efficacy and tolerability of St. John's wort extract LI 160 versus
imipramine in patients with severe depressive episodes according to ICD-10
- Pharmacopsychiatry 1997 Sep;30 Suppl 2:81-5 -
"6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in
severely depressed patients according to ICD-10 ... mean values 25.3 to 14.5
in the LI 160 group and 26.1 to 13.6 in the imipramine group ... Regarding
adverse events, the nonrejection of the nonequivalence hypothesis denotes a
superiority of the herbal antidepressant. These main result indicate that LI
160 might be a treatment alternative to the synthetic tricyclic
antidepressant imipramine in the majority of severe forms of depressions"
- Comparison of an extract of hypericum (LI 160) and sertraline in the
treatment of depression: a double-blind, randomized pilot study
- Medline/Clin Ther 2000 Apr;22(4):411-9, 4/00 -
"Clinical response (defined as a > or =50% reduction in HAM-D scores) was
noted in 47% of patients receiving hypericum and 40% of those receiving
sertraline ... The [LI 160] hypericum extract was at least as effective as
sertraline in the treatment of
mild to moderate depression in a small group of outpatients"
- Neuroendocrine evidence for dopaminergic actions of hypericum extract (LI
160) in healthy volunteers - Biol Psychiatry 1999
Aug 15;46(4):581-4 -
"Following HP relative to placebo,
there was a significant increase in plasma GH [growth
hormone] and a
significant decrease in plasma PRL [prolactin]"
- Note: Prolactin is bad for your sex like.
- Hypericum LI 160 inhibits uptake of serotonin and norepinephrine in
astrocytes - Brain Res 1999 Jan 23;816(2):358-63 -
"We found that LI 160
inhibited both serotonin and norepinephrine uptake in a dose-dependent
manner"
- Acute effects of LI 160 (extract of Hypericum perforatum, St John's wort)
and two of its constituents on neuroendocrine responses in the rat
- J Psychopharmacol 2000;14(4):360-3 -
"LI 160 also lowered plasma prolactin and prevented the increase in plasma
prolactin following haloperidol administration" - Note:
Prolactin is bad for your sex life.
- Effectiveness and tolerance of the hypericum extract LI 160 in comparison
with imipramine: randomized double-blind study with 135 outpatients
- J Geriatr Psychiatry Neurol 1994 Oct;7 Suppl 1:S19-23 -
"a parallel reduction of the Hamilton score from 20.2 to 8.8 (LI 160, n =
67) or from 19.4 to 10.7 (imipramine, n = 68) ... In the LI 160 group fewer
and milder side effects were found as compared to imipramine"
- St. John's wort study was financed
and biased by Pfizer, makers of Zoloft - Ben
- Questions About St. John's Wort - Intelihealth,
4/25/01
- Study: St. John's wort ineffective in severe depression
- CNN, 4/18/01 - "At the time the
study was done, Pfizer also sold St. John's wort, but the company stopped
selling herbs last year because it wasn't profitable" -
That's the whole problem in a nutshell, Ben
- Depressing News: St. John's Wort May Not Work After All, Don't Believe the
Hype, Says Researcher - WebMD, 4/17/01
-
Comparison of an extract of hypericum (LI 160) and sertraline
in the treatment of depression: a double-blind, randomized pilot study
- Medline/Clin Ther 2000 Apr;22(4):411-9, 4/00 - "Clinical response (defined as a > or =50% reduction in HAM-D
scores) was noted in 47% of patients receiving hypericum and 40% of those
receiving sertraline ... The [LI 160] hypericum extract was at least as
effective as
sertraline in the treatment of mild to moderate depression in a small
group of outpatients"
-
Medline search of LI 160
WS 5572 Extract (Perika
Brand in US, Neuroplant 300 brand in Germany):
WS 5570 Extract (contains at least 4%
hyperforin but I don't believe it's available)/(Perika
Brand in US, Neuroplant 300 brand in Germany):
-
Continuation and long-term maintenance treatment with Hypericum extract WS((R))
5570 after recovery from an acute episode of moderate depression - A
double-blind, randomized, placebo controlled long-term trial - Eur
Neuropsychopharmacol. 2008 Aug 9 - "3x300 mg/day
WS((R)) 5570 or placebo for 26 weeks. 426
patients were evaluated for efficacy. Relapse rates during continuation
treatment were 51/282 (18.1%) for WS((R)) 5570 and 37/144 (25.7%) for placebo.
Average time to relapse was 177+/-2.8 and 163+/-4.4 days for WS((R)) 5570 and
placebo, respectively (time-to-event analysis; p=0.034; alpha=0.025 one-sided).
Patients treated with WS((R)) 5570 showed more favorable HAMD and Beck
Depression Inventory time courses and greater
over-all improvement (CGI) than those randomized to placebo. In long-term
maintenance treatment a pronounced prophylactic effect of WS((R)) 5570 was
observed in patients with an early onset of depression as well as in those with
a high degree of chronicity. Adverse event rates under WS((R)) 5570 were
comparable to placebo. WS((R)) 5570 showed a beneficial effect in preventing
relapse after recovery from acute depression. Tolerability in continuation and
long-term maintenance treatment was on the placebo level"
-
New Study Finds Different Results on Efficacy of St. John's Wort for
Depression - Clinical Psychiatry News, 3/05 -
"extract WS 5570 ... Patients whose
initial response was insufficient could increase the dose of hypericum
extract to 1,800 mg/day or of paroxetine to 40 mg/day ... response rates
were 60% in the hypericum group and 63% in the paroxetine group, while
remission rates were 46.6% with hypericum and 42.9% with paroxetine"
- Note: The WS 5570 extract is sold under the Perika(R) brand name.
-
Acute treatment of moderate to severe depression with
hypericum extract WS 5570 (St John's wort) - NPI
Center, 2/11/05 - "This extract
(WS(R) 5572) contains the same patented, standardized and stabilized hyperforin content as WS(R) 5570, and is marketed as Perika(R) St. John's
Wort by Nature's Way Products, Inc"
- St. John's Wort Useful for Severe Depression -
WebMD, 2/10/05 -
"At the end of six weeks, 71% of the patients taking St. John's Wort and 60%
of those taking Paxil had responded to treatment. Half of the St. John's
Wort-treated patients and 35% of the Paxil-treated patients were free of
depression symptoms"
- Efficacy of St. John's wort extract WS 5570 in major depression: a
double-blind, placebo-controlled trial - Am J
Psychiatry 2002 Aug;159(8):1361-6
-
Neuroendocrine effects of Hypericum extract WS 5570 in 12 healthy male
volunteers - Pharmacopsychiatry 2001 Jul;34 Suppl 1:S127-33
-
Medline search of WS 5570
STW3-VI Extract:
Other News:
-
Depression Protocol - Life Extension Foundation
- St. John's
Wort, Nature's Feel Good Herb - Ray Sahelian, M.D.
- St.
John's wort - Compiled by Chad Bradshaw, Pharm.D
-
St. John’s Wort Extract - Dr. Murray -
"German doctor's now prescribe St. John's wort extract 8 times more often
than Prozac ... These doctors are knowledgeable about both medicines, but
clearly favor St. John's wort extract. Why? The simple answer is that St.
John's wort produces equal or better results in relieving depression, but
has far fewer side effect. Over 25 double-blind randomized trials involving
a total of 1,757 outpatients with mild to moderately severe depression have
shown St. John's wort extracts standardized for hypericin to yield excellent
results in the treatment in depression with virtually no side effects"
- I
read somewhere that when taking St. John’s wort extract that it is important
to stay away from the sun and avoid red wine and cheese. Is this true? -
Dr. Murray
-
St. John's Wort (Hypericum perforatum L.) - M. D. Anderson Cancer Center
-
Effects
of a Combination of Hypericum perforatum and Vitex agnus-castus on PMS-Like
Symptoms in Late-Perimenopausal Women: Findings from a Subpopulation
Analysis - J Altern Complement Med. 2009 Sep;15(9):1045-8 -
"At the end of the 16-week treatment phase, analyses
of covariance showed the herbal combination to be superior to placebo for
total PMS-like scores (p = 0.02), PMS-D (p = 0.006), and PMS-C clusters (p =
0.027). The active treatment group also showed significant reductions in the
anxiety (p = 0.003) and hydration (p = 0.002) clusters, using paired-samples
t tests. Results of trend analyses showed significant treatment group
effects across the five phases for total PMS and all subscales, all in the
clinically expected direction" - See
Kira® (LI 160 extract) St. John's wort at iHerb
and
chaste berry products at iHerb.
-
Effects
of Hypericum perforatum (St. John's wort) on hot flashes and quality of life
in perimenopausal women: a randomized pilot trial - Menopause. 2009 Feb
3 - "After 3 months of treatment, compared with the
placebo group, women in the St. John's wort group reported significantly
better menopause-specific quality of life (P = 0.01) and significantly fewer
sleep problems (P = 0.05) ... Hypericum perforatum may improve quality of
life in ways that are important to symptomatic perimenopausal women"
-
St. John's Wort for Depression - Clinical Psychology News, 12/08 -
"The best available evidence suggests that St.
John's wort is better than placebo for treating major depressive disorder,
is as effective as some synthetic antidepressants when used in low to
moderate dosing ranges, and has fewer side effects than do synthetic
antidepressants"
-
St. John's Wort Holds Its Own in Meta-Analysis - Clinical Psychology
News, 11/08 - "St. John's wort was more effective
than placebo and just as effective as standard antidepressants in treating
depression, a Cochrane analysis of 29 studies of almost 5,500 adults with
major depression shows" - See
Kira® (LI 160 extract) St. John's wort at iHerb.
-
St.
John's Wort Relieves Symptoms Of Major Depression, Study Shows - Science
Daily, 10/13/08 - "Cochrane Researchers reviewed 29
trials which together included 5,489 patients with symptoms of major
depression. All trials employed the commonly used Hamilton Rating Scale for
Depression to assess the severity of depression. In trials comparing St.
John's wort to other remedies, not only were the plant extracts considered
to be equally effective, but fewer patients dropped out of trials due to
adverse effects" - See
Kira® (LI 160 extract) St. John's wort at iHerb
and
Perika (WS 5570 extract) at iHerb.
-
St. John’s Wort for Major Depression? - WebMD, 10/10/08 -
"Can taking an herbal supplement be as good as a
prescription medication for people who are severely depressed? ...
Researchers in Germany think so" - See
Kira® (LI 160 extract) St. John's wort at iHerb
and
Perika (WS 5570 extract) at iHerb.
-
Taking herb 'helps depression' - BBC News, 10/8/08 -
"Overall, the St John's Wort extracts tested in the
trials were superior to placebo, similarly effective as standard
anti-depressants, and had fewer side effects ... Doctors think it works
because the herb keeps serotonin, a chemical which makes you happy, in the
brain for longer"
-
St. John's Wort and Duloxetine Equally Effective in Mild to Moderate
Depression - Doctor's Guide, 9/1/08 - "Twenty
patients received St. John's Wort at a dosage of 900 mg QD, whereas the
remaining 20 participants were treated with duloxetine 60 30 mg QD ... In
the group of patients suffering from moderate depression, we did not find
any statistically significant differences between the 2 treatment groups"
- See
St. John's wort products at iHerb.
- St.
John's Wort review - ConsumerLab.com, 2/15/07 -
"most of the herbal supplements that we
purchased failed to meet quality standards. Two contained less St. John's
wort compounds than claimed. Two others were contaminated with cadmium
and/or lead. And two more lacked proper label information"
-
Botanical and dietary supplements for mood and anxiety in menopausal women
- Menopause. 2006 Dec 28 - "Five of
seven trials of St. John's wort for mild to moderate depression showed a
significant improvement"
-
Serotonin syndrome has been reported in patients who used both St. John's
Wort and an SSRI - Clinical Psychiatry News, 11/06 -
"The evidence is strongest for the
psychotropic herb St. John's wort, which appears to induce cytochrome P450
(CYP450) enzyme systems, particularly 3A4, leading to substantial reductions
in drug substrates, including antivirals and cancer chemotherapy agents"
-
Is St. John's
Wort Effective for Major Depression? - New Hope Natural Media Online,
8/10/06
-
Black Cohosh/St. John’s Wort could ease menopause symptoms
- Nutra USA, 3/2/06 -
"The most common symptom of menopause, “hot flashes” characterized by sudden
waves of body heat, decreased by 53.4 percent among women who took the Black
Cohosh-St. John's Wort combo in the trial, while psychological, or “psyche”,
symptoms reportedly dropped by 56.4 percent"
-
St. John's Wort May Not Stop Major Depression - WebMD, 5/24/05
-
St.
John's Wort Only Minimally Effective In Relieving Major Depression, Review
Confirms - Science Daily, 5/22/05 -
"St. John’s Wort products should be
avoided if they do not provide important content information, such as the
amount of total extract contained, the extraction fluid used and the ratio
of raw material to extract" - Note: Most of the studies I've
seen involve the LI 160 extract sold in the US under the
Kira®
brand.
-
St. John's Wort and
Plavix May Be Risky Combo - WebMD, 3/8/05 -
"St. John's wort, used by many for
depression, increases the effect - and the bleeding risk - of Plavix, a
widely used blood thinner"
-
St. John's Wort - Imatinib Drug Interactions
- Medscape, 12/17/04 - "Coadministration
of imatinib with St. John's wort may compromise imatinib's
clinical efficacy"
- St.
John’s Wort: Good for More than Depression - Healthwell, 10/21/04 -
"SDs are a group of conditions characterized by several ongoing physical
symptoms that cannot be explained by any identifiable illness ... Among
those participants receiving SJW, 44% reported being completely improved,
compared with only 25% in the placebo group. In contrast, 45% of the
participants in the placebo group felt unchanged or worse compared with 17%
in the SJW group. By the end of the study, one half of the participants
taking SJW had improved so much that they were no longer considered to have
SD"
- St. John's Wort Thwarts Cancer Drug - WebMD,
10/26/04
- St John's Wort May Reduce Bioavailability of Conventional Medications
- Doctor's Guide, 7/6/04
- St. John's Wort Depletes Cancer-Fighting Drug -
WebMD, 3/26/04 -
"when St. John's wort is taken in combination with Gleevec, it caused the
amount of Gleevec in the blood to drop by 30%"
- Caution: St. John's Wort Ingredients Vary - WebMD,
2/10/04
- What's Really In Your St. John's Wort Tablets? -
Intelihealth, 2/9/04 - "Actual
amounts of hypericin ranged from 1.7 to 38.5 percent of the claimed amount"
-
St. John's Wort - Natural Foods Merchandiser, 10/03 -
"Recently, in a large trial comparing SJW with the conventional
antidepressant imipramine, researchers concluded SJW is as effective as
imipramine and is better tolerated by patients.13 In a newer, larger trial
(240 participants) comparing SJW directly with fluoxetine, researchers
concluded SJW was as effective and safer than fluoxetine, particularly in
patients suffering depression and anxiety"
- St John's Wort Alters Enzymes Involved in the Metabolism of About 50% of
Over-the-Counter and Prescription Medications
- Doctor's Guide, 9/18/03 -
"long-term administration of St John's wort may
result in diminished clinical effectiveness or increased dosage requirements
for all CYP 3A4 substrates, which represent
at least half of marketed medications" - The way I understand it, the
enzyme that SJW increases protects the liver. JAMA always seems to be
biased against supplements, which might be why they didn't mention that.
Have they ever mentioned the pitfalls of
prescription drugs?
- St.
John's Wort Increases Metabolism Via CYP 3A4 -
Medscape, 9/16/03
-
St. John's Wort for Depression - Clinical Psychiatry News, 1/03 -
"Most St. John's wort preparations are standardized to the hypericin
component. This compound has been shown to reduce 5-hydroxytryptamine (5-HT)
receptor density; weakly inhibits reuptake of 5-HT,
norepinephrine, and
dopamine; and binds to -aminobutyric acid (GABA)
receptors ... It also has MAO inhibitor activity
... In biochemical and animal studies, the researchers wrote, hyperforin
also inhibits the synaptosomal
uptake of 5-HT, noradrenaline, dopamine, glutamate, and GABA"
-
St. John's Wort May Help Depression in Children - Clinical Psychiatry
News, 1/03
-
Antidepressants Aren't All They're Cracked Up to Be - Clinical
Psychiatry News, 1/03 -
"The fact is, the stringent inclusion
and exclusion criteria routinely used in pharmacologic
antidepressant clinical trials enable investigators to paint an
unrealistically rosy picture of the drugs' performance. This renders the
trials largely irrelevant to real-world clinical practice" - That's
an important consideration with the Pfizer (makers of Zoloft) funded St.
John's wort study.
- St. John's Wort and Chemo Don't Mix - WebMD,
8/20/02 - "Taking St. John's wort
during chemotherapy could jeopardize the
effectiveness of cancer treatment" - Again, I'm not a doctor but the
way I understand it, SJW increases an enzyme that protects the liver.
It seems like that would be a good thing for most people. Again, why
didn't the media mention that instead of being so one sided?
- St. John's Wort: Effective, with Caveats -
Nutrition Science News, 3/02 -
"Using the Hamilton Rating Scale for Depression, 47 percent of those taking
St. John's wort improved compared with 40 percent of those taking the
sertraline ... Hyperforin increases the effectiveness of
norepinephrine, dopamine, L-glutamate, and
gamma-amino butyric acid (GABA),
as well as serotonin. Researchers in the
Department of Pharmacology at the University of Frankfurt in Germany
concluded, "no other antidepressant compound exhibits a similar broad
uptake-inhibiting profile.""
- Hypericum, Drug Interactions, and Liver Effects -
Medical Herbalism, Medical Herbalism (2000)11(2):16) -
"The specific enzyme system whose activity was increased in the test
subjects is the CYP3A, part of the p450 microsomal enzyme system,
responsible for Phase I detoxification in the liver"
- Prozac and I'm sure others alter the P450 enzymes also.
See:
- Characterising Fluvoxamine Metabolism - Doctor's
Guide, 4/19/02 -
"the higher fluvoxamine doses inhibited CYP1A2 and CYP2C19 by approximately
75 to 80 per cent. The inhibition with the lower doses was around 40 to 50
per cent"
- A Novel Mechanism For St John's Wort Drug Interactions
- Doctor's Guide, 1/25/02
- Depression Management - ContinuingEducation.com,
exp. 12/31/02 - "The results of at
least one trial suggest that Hypericum,
used in higher doses, may be considered a therapeutic alternative in
patients with moderate to severe depression"
- Evaluation of the Association Between St. John's Wort and Elevated
Thyroid-Stimulating Hormone - Medscape, 12/01 -
"This study suggests a probable association between St. John's wort and
elevated TSH levels ... In one patient, TSH dropped from 18.63 to 5.37 µU/ml
1 month after discontinuing St. John's wort, and subsequently to 1.32 µU/ml
6 months later. In the second patient, TSH decreased from 14.76 to 3.23
µU/ml 1 month after discontinuation of the herb ... Although the
similarities between St. John's wort and tricyclic antidepressant drugs are
less clear, it has been postulated that tricyclic antidepressants interfere
with the hypothalamic-pituitary-thyroid axis through noradrenergic or serotonergic systems, indirectly decreasing T4 or
triiodothyronine (T3) levels in the blood"
-
Is St. John's wort an effective treatment for depression? - Nutrition
Science News, 9/01
-
St. John's Wort Vs. Drugs - Nutrition Science News, 6/01 -
"Yet recent clinical trials have shown that St. John's wort works as well as
Prozac, Zoloft and other leading antidepressant drugs for treating mild to
moderate depression"
- Hypericin
May Be Potential Candidate For Treating Esophageal Cancer - Doctor's
Guide, 5/22/01 - "Hypericin, the
active ingredient in St. John’s Wort, a popular herbal remedy for
depression, may be a potential candidate for treating esophageal and other
tumors"
-
Effects of long-term administration of hypericum extracts on the affinity
and density of the central serotonergic 5-HT1 A and 5-HT2 A receptors -
Pharmacopsychiatry 1997 Sep;30 Suppl 2:113-6 -
"the number of both 5-HT1 A and 5-HT2 A receptors were significantly
increased by 50% compared to controls"
-
Popular Herb Works for Obsessive-Compulsive Disorder - WebMD, 8/17/00
-
Herb May Curb PMS - WebMD, 8/7/00
-
St. John's Wort Passes Muster - Nutrition Science News, 4/00
- Hypericum, Drug Interatcions, and Liver Effects -
MedHerb.com, 2/00 - "Endogenous
hormones metabolized by the CYP3A enzyme system - estradiol, estriol,
testosterone, cortisol"
- Study 20 -
The Hypericum Homepage - "Both
serum-cortisol and serum-prolactin
were lowered significantly after three weeks of treatment with hypericum
extract in male rats."
- Natural Remedies for Depression - Nutrition
Science News, 2/99
-
Antidepressant Can Change Personality Traits In Healthy People -
Doctor's Guide, 3/2/98
- Scientists
Study How Light Activates St. John's Wort Chemical
- Doctor's Guide, 12/4/97
- Hypericum (St. John's
Wort) & Depression Home Page
- Brain's
Serotonin System Declines With Age, Researchers Report - Doctor's Guide,
10/29/97
-
St. John's Wort may offer herbal relief for depression - CNN, 8/3/96
-
Study: Anti-depressant helps relieve severe PMS - CNN, 9/23/97
I'm not a doctor and what I write should not be
taken as medical advice. With that said, I should be able to talk about what
I've read without being sued for medical malpractice. (Isn't there
something in the First Amendment?).
The more I read about St. John's wort, the more
I'm convinced that it the best anti-depressant on the market - prescription or
non-prescription. St. John's has several advantages over other anti-depressants.
For one thing, it increases all three of the brains primary nero-transmitters -
serotonin, norepinephrine and dopamine (dopamine and norepinephrine are
aphrodisiacs, norepinephrine is associated with increased energy). The only
other anti-depressant that does that is Effexor, but it is week on
norepinephrine and dopamine. One of the things that used to worry me about St.
John's wort was that most of the studies were done comparing it to imipramine
and I didn't believe that imipramine was a very good anti-depressant because it
is seldom used. After doing more research, I discovered that imipramine is one
of the most effective anti-depressants available but most people prefer other
anti-depressants because of the severe side effects of imipramine.
There is a new anti-depressant called reboxetine,
which is made by Upjohn and sold in Europe and awaiting FDA approval in the US.
In trials, patients on reboxetine and imipramine had mean Hamilton scores of 1.1
while patients on fluoxetine (Prozac) had a mean score of 2.6 and patients on
placebo had a score of 4.7 (Severe depression
responds to new class of antidepressants - Reuters, 6/9/98). What that shows
is that both reboxetine and imipramine are nearly identical in effectiveness and
are more than twice as effective as Prozac. The advantage of reboxetine over
imipramine is that it has much less side effects than imipramine. Yet, in every
study comparing imipramine and St. John's wort, the difference in the results
was negligible. Plus, St. John's wort has far less side effects.
There are several other advantages to St. John's
wort. It is a mild inhibitor of both MAO-A and MAO-B. St. John's wort also
inhibits the action of interleukin-6, a cytokine that may contribute to the
increased cortisol
production noted in major depression.
St. John's wort has anti-viral and anti-bacterial
properties. It also contains carotenoids, flavonoids and beta-sitosterol which
have been associated with decreased cancer and anti-oxidant effects. It contains
proanthocyanidins which is the same compound at Pycnogenol (20 times more
powerful than vitamin C and 50 times more so than vitamin E).
I read articles claiming that St. John's wort is
only for mild to moderate depression. I guess they say that because there is
only one trial that I know of where is has used for severe depression. In
that trial, St. John's wort compared quit favorably with imipramine (one of the
most effective anti-depressants available).
St. John's wort has been used in trials up to
3600 mg per day. It seems like in all the studies, they used 300 mg of St.
John's wort as the equivalent of 25 mg of imipramine. If you use the
Vorbach/Arnoldt 1997 study and assume a linear relationship, I calculate
that you need 12.5% more St. John's wort and come up with 2700 mg of St. John's
wort should equal 200 mg of imipramine (the amount of imipramine used for severe
depression). Again, you should always do things in conjunction with as
physician. One reason is that there is the concern over serotonin syndrome
which can be fatal.
Ben
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