Last week I wrote about light box therapy, and other ideas, for improving mood in SAD (seasonal affective disorder). A more conventional approach to SAD is pharmaceutical antidepressant therapy with, for example, SSRI (selective serotonin reuptake inhibitors) type antidepressants which include fluoxetine (Prozac) and paroxetine (Paxil, Seroxat). However, these drugs come with certain side effects (including an increased risk of suicide attempts) and their effectiveness has also been questioned. For these reasons, many individuals seek alternative ways of dealing with low mood. One well recognised natural agent is the herb St John’s wort (Hypericum perforatum). Historically this plant has been used as a remedy for the treatment of depression and there is now quite a bank of medical and scientific evidence(1) confirming the effectiveness of this herb for aiding various mood disturbances.
St John’s wort is a shrubby perennial plant with bright yellow flowers, named after St John the Baptist. Ancient Greeks and Romans believed that the herb could deter evil spirits but today it is mainly used as a natural, alternative to antidepressants. The herbal supplements are made from the dried flowers of the plant. The herb has been routinely used in Germany for many years where doctors and health practitioners frequently prescribe supplements for depression.
Very recently a paper was published (1) reviewing the available evidence for the use of St John’s wort in the treatment of depression. The review included 29 high quality studies (randomised and double-blind) from a variety of countries, the studies included a total of 5489 patients and ranged from 4 weeks to 12 weeks in length. The researchers found that, for people suffering from mild to moderate depression, St John’s wort can provide effective relief, similar to that of standard antidepressants but with fewer side effects.
The authors note, and it is important to state, that people suffering from depressive symptoms (including a low mood, loss of interest or pleasure in life and activities) who wish to use a St John’s wort product should ALWAYS consult a doctor. The quality of products available on the market varies widely and the herb can interact with other medications so it is always best to check with a medical practitioner before embarking on a treatment plan.
The antidepressant properties of St John’s wort are thought to be ascribed to the compounds hypericin and hyperforin that are contained within the herb. It is not entirely known how the herb works to lift the mood but it seems to act on certain ‘feel-good’ brain chemicals (known as neurotransmitters) such as dopamine, serotonin and noradrenaline.
The typical recommended dose is 300mg of St John’s wort extract three times a day for supplements standardised to contain 0.3% hypericin. One a day supplements containing 900mcg hypericin are also available. ALWAYS check with a doctor before taking the herb. It may take 4 weeks before you see any benefit. Side effects are uncommon, however in people with fair skin it is advisable to avoid prolonged exposure to sunlight whilst taking the herb.
The herbal supplement also seems useful for the treatment of other mood disturbances such as anxiety, apathy, insomnia, stress and SAD, if you think you could benefit from taking St Johns wort I would suggest chatting with a health professional prior to undertaking a supplementation regimen.
(1)Linde K et al. 2008. St John’s wort for major depression. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD000448. DOI: 10.1002/14651858.CD000448.pub3
Written by Ani Kowal