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St John’s wort and depression

St John’s wort otherwise known as Hypericum perforatum has been used medicinally since ancient Greek times, when, it is believed Dioscorides and Hippocrates used it to rid the body of evil spirits. Paracelsus (c 1493-1541) prescribed it for anxiety, neurosis and depression. It has enjoyed its greatest popularity in Europe and comprises of 25% of all antidepressant prescriptions in Germany! This strong historical and current evidence suggests that there has to be something to this wonderful yellow flowering plant.

As with all herbal preparations, the quality of the product will determine the outcome. Just as a colleague described that you can’t compare cask wine to an expensive drop of exclusive wine; neither can you compare any old product with some of the standardised, carefully processed and well manufactured products that are available to qualified herbalists. St John’s wort can only be considered a viable alternative if the quality of the product is guaranteed.

Quality extracts have been shown to be a successful treatment for mild-moderate depression in numerous double-blind-placebo-controlled studies (the best study type available) and has also been confirmed by multiple meta-analyses. A recent Cochrane review analysed data from over 37 of these well designed studies and found that hypericum extracts improved symptoms more than placebo and produced effects similar to synthetic antidepressants (tricyclics and SSRIs).

This basically means that for the application of mild-moderate depression it is wonderfully successful when the right prescription is used (not just any old product from the chemist or supermarket). However, take note – I only said mild-moderate depression. If depression is moderate-severe or severe I wouldn’t wait for the St John’s wort to kick in. I would suggest you see your Doctor asap and consider pharmaceutical anti-depressants. We’re not talking about a simple condition. Depression is complicated and potentially dangerous. Herbal medicines have their place in medicine but a realistic approach is essential.