St. John’s Wort Outdoes Antidepressant Drugs

February 14, 2005

It is better to take St. John’s Wort than Anti-Depressant Drugs, even when suffering from a moderate to a severe depression. It not only works better but it has fewer side effects. But every second patient needs a double dose.”…

Taking St. John’s wort is better than taking antidepressant drugs, even in the case of moderate to severe depressions. The effect is better and it has fewer adverse effects. However, every other patients needs a double dose for the herb to be effective.

The fact that St. John’s wort can be used for other things than making schnapps has been known for some time. As early as in 1994 it turned out that the plant can be used for even serious depressions, and St. John’s wort has been an unlicenced herbal remedy for some time now.

On account of the usual hypocrisy of the authorities, the remedy is only approved for treating “melancholy, despondency, and sadness”; concepts that are not used in the scientific world of approved licensed medical drugs. It has been documented, however, that St. John’s wort is effective against depression; but the hyprocrisy forbids informing about this even though it is specifically the word of “depression” that is used in the scientific articles.

In Germany, the authorities are truthful and here, St. John’s wort has been officially approved for “mental disturbances, depressive conditions, anxiety, and nervous restlessness” since 1984.

For this reason, German doctors have used far more St. John’s wort than their British colleagues and have spared their patients of nausea, tiredness, impotence, oral dryness, dizziness, sleeplessness, and what else might come from using antidepressants – also called SSRI preparations. In Germany, St. John’s wort is prescribed twice as often as standard antidepressants.

So far, it has been known that St. John’s wort is just as effective against light depression as SSRI preparations and other antidepressants. When it comes to severe depressions, there has been more doubt about its effectiveness even though a study indicated that the effect was fully equal to prescription drugs. However, the study was too small for the results to be valid.

This uncertainty has now been removed. An unusually well accomplished German study performed with typical German thoroughness has documented that not only is St. John’s wort fully equal to the SSRI remedies; it actually outdoes them. In a study involving 244 severely depressed patients, St. John’s wort had both a better effect and caused fewer adverse effects than the widely used SSRI preparation paroxetine.

The study showed that adverse effects only appeared half as often in the group receiving St. John’s wort as in the group receiving paroxetine. After six weeks, the patients who had been treated with St. John’s wort noted a decrease in depression score of 57% while the patients who had been treated with paroxetine could only note a decrease of 45% – scored on the basis of the so-called Hamilton depression rating scale.

In all respects, this study lives up to the highest standards. There are therefore very strong reasons for preferring St. John’s wort to other remedies – in both mild and moderate to severe depression.

You should be aware of two things, however: First of all, the recommended dose in the over-the-counter drugs is generally too small: They advise you to take e.g. 3 – 6 tablets which gives you a total of 900 – 1800 mg of hypericin if the content of hypericin is 300 mg per tablet. The 900 mg is too small a dose.

In the German study, 900 mg was the starting dosage. Approximately every other patient had that dosage doubled after 14 days due to a lacking effect. This means that with Danish pills (450 milligrams hypericum / tablet) you either have to start with 2 and possibly increase to 4 tablets a day to get the same effect as the German trial subjects!

The second thing you should know is that St. John’s wort reduces the effect of several kinds of drugs, including prescription drugs such as contraceptive pills and anticoagulants. The reason for this is that St. John’s wort promotes the breakdown of the drugs in the liver. If you are taking any kind of medicine, you should consult your doctor before starting self-treatment with St. John’s wort!

By: Vitality Council

1. Szgedi A et al. Acute treatrment of moderate to severe depression with hypericum extract WS 5570 (St Johns Wort): randomised controlled double blind non-inferiority trial versus paroxetine. BMJ online 11.2.2005, page 1-6.
2. de Smet P.A.G. et al. St Johns wort as an antidepressant. BMJ 1996;313:241-2 (L).
3. Linde K et al. St Johns wort for depression – an overview and meta analysis of randomised clinical trials. BMJ 1996;313:253-7.