Is St John’s Wort the Ultimate Natural Self Remedy Herb For Depression?

St. John’s wort has received widespread attention as a natural and effective way to treat depression. Sales of St. John’s wort extracts have skyrocketed in recent years as more and more Americans self-medicate with this herb, which is available over the counter.

The selling points of St. John’s wort are that it is “natural,” it causes fewer side effects than antidepressants, and it eliminates the need to work with a doctor while helping to reduce depressive moods. A spate of clinical trials conducted in Europe found that St. John’s wort has antidepressant activity in mild to moderate cases of depression.

It is not, however, a reliable substitute for antidepressants in people who are diagnosed with moderate to severe depression. Nor is it known to be effective for the myriad of non-depressive disorders that antidepressants treat.

I have a number of concerns about St. John’s wort. My biggest is that it may cause toxic interactions if you’re taking another antidepressant at the same time. I’ve had a number of patients come to me on an antidepressant and self-administered St. John’s wort, unaware of the potential dangers. Researchers aren’t exactly sure how the herb works.

It may act like an MAO inhibitor, like an SSRI, or perhaps like both. Serious and even fatal reactions, including hypothermia and coma, have occurred when people have taken Prozac in combination with an MAO inhibitor.

This means that if you’re taking Prozac or some other SSRI, you could have a potentially serious reaction when you add St. John’s wort to the mix, since there’s a possibility that it has some MAO inhibiting effects. The bottom line is that combining antidepressants and St. John’s wort is uncharted and potentially dangerous territory.

Another concern I have is the unreliability of some companies that produce St. John’s wort. I worry that depressed people who believe that St. John’s wort is equivalent to other antidepressants might treat themselves unsuccessfully.

If they use a brand that is low in quality, they will not have a good response and may conclude that no treatment will work. Finally, it is important to understand that the fact that a substance is found in nature doesn’t mean it is safe. Arsenic, for instance, is a natural element that is highly toxic in minute amounts. Most important, the vast majority of the patients I see have multiple biochemical abnormalities that St. John’s wort won’t affect.