St. John’s Wort and Depression
St. John’s wort (Hypericum perforatum) is frequently prescribed in Germany for the treatment of mild to moderate depression. Research has indicated that using St. John’s wort can significantly relieve the symptoms of depression, with people showing an improvement in mood and ability to carry out their daily routine. In addition, symptoms such as sadness, worthlessness, hopelessness, and insomnia also decrease.
Numerous clinical studies have reported that St. John’s wort is more effective than placebo, with results similar to SSRIs. A study at the University of Vienna analyzed three double-blind trials that included 544 out-patients suffering from mild to moderate depression who received St. John’s wort or placebo. Researchers concluded that St. John’s wort reduced the symptoms of depression more effectively than placebo and accelerated the recovery from depression.
One review of 23 randomized trials that included a total of 1,757 outpatients with mainly mild to moderately severe depressive disorders noted that here was “evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders.”
Other double-blind, placebo-controlled studies have examined the effectiveness of St. John’s wort for the treatment of mild to moderate major depression, and most have found the herb at least as effective as antidepressant medications. St. John’s wort extract has been compared favorably to the prescription antidepressants paroxetine (Paxil), citalopram (Celexa), imipramine (Tofranil), amitriptyline (Elavil), fluoxetine (Prozac), maprotiline (Ludiomil), and sertraline (Zoloft). In these studies, the improvement in depressive symptoms in people taking St. John’s wort was similar or better than the antidepressants, often with far fewer side effects.
One clinical trial compared a higher amount of the St. John’s wort with imipramine in severely depressed patients. The overall improvement of both groups was virtually the same with far fewer side effects for the St. John’s wort group.
While studies worldwide point to St. John’s wort as effective for depression, treatment should be done under the guidance of a healthcare professional. One of the problems with trying to determine the efficacy of any supplement, herb, or antidepressant is that they all react differently in each person. This variable can be pronounced in people with depressive disorders, further enforcing the need for a qualified medical evaluation.