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Johns Hopkins Health Alert

Natural--but not Always Harmless--Remedies for Depression and Anxiety

Comments (6)

 

  • Recent reports have illustrated that St. John's wort, used by many people to relieve depression, may not be as benign as it appears.

Despite the availability of a full arsenal of medications proven to be effective for treating depression and anxiety, many people have turned to herbal remedies—which are classified as dietary supplements in the United States and so have not been tested or approved by the U.S. Food and Drug Administration (FDA). No one is sure how well they work as a treatment for depression and anxiety or how they may interact with prescription medications, nor is there any guarantee of the purity of any herbal product you buy.

In addition, one concern with any alternative treatment is that people tend to medicate themselves instead of being evaluated and monitored by a health professional. As a result, they may not recognize worsening symptoms.

St. John's wort, which is extracted from a yellow flowered plant called Hypericum perforatum, is the best known of the supplements purported to be natural antidepressants. The American College of Physicians and the American Society of Internal Medicine recently included St. John’s wort in their guidelines as a treatment option for mild depression, but two large studies published in the Journal of the American Medical Association found that St. John's wort was no more effective than a placebo for treating major depression. A recently publsihed overview of research on the herb notes that studies conducted to date have produced "inconsistent and confusing" results.

Thus, it is recommended that people with major depression not take St. John's wort until well-designed studies support its use. People with mild to moderate depression should use caution and be sure to consult their doctors before using it.

Recent reports have illustrated that St. John's wort may not be as benign as it appears. Researchers have shown that St. John's wort lowers blood levels of Crixivan (indinavir), a drug prescribed for HIV (human immunodeficiency virus) infection as well as Sandimmune (cyclosporine), a drug given to prevent organ rejection in transplant patients. Physicians suspect that St. John's wort might interfere with a range of medications, including those prescribed to treat depression, heart disease, seizures and some cancers. St. John's wort may also cause increased sensitivity to the sun.

Kava, which is prepared from the crushed root of Piper methysticum (a shrub-like pepper plant), is marketed as a natural remedy for anxiety and stress. However, the FDA has issued a warning that the supplement can damage the liver. In addition, long-term use of kava may result in allergic reactions, visual disturbances, or difficulties maintaining balance. Kava should not be used if you are pregnant, breast feeding or taking antidepressants.

Posted in Depression and Anxiety on May 23, 2006
Reviewed June 2011


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


When I feel upset and have trouble sleeping I take Valerian Root before bedtime. I've been buying it cheaply in powder form at my local "Food For Less" market; but I also started a couple plants in my garden. I plan to process this stinky weed myself.

This is the only drug I take for my insomnia. At age 68 I am in excellent health and do not take (or have any use for) any prescription medications. I do imbibe fish oil, and I eat a (nonstandard for Americans) healthy diet. Oh yes, and I make sure I get lots of regular exercise.

I take care of older people. Most didn't take decent care of themselves. Instead, they depended entirely on doctors and prescription medication to keep them healthy.

I welcome any comments, for or against, my ways of "self medicating," and "self therapy."

Posted by: Oregon Caregiver | August 20, 2006 8:35 PM

I think that each individual should be responsible for their health and useing a health joural is a good way to do this. Doctors are already overburdened and have trouble remembering so many patients, time limits and ailments. Doctors are helpfull and many times fix the things we neglect but shouldnt be our only source for relying on optimal health. I love it that people now can check their own blood pressure, take some independent lab tests such as cholesterol and know some of the signs of health or sickness.

Posted by: Cherat51 | January 31, 2007 2:16 PM

I dont like the wording that in the article about St Johns Wort, that the studies found it does work for mild depression, but not for moderate to severe as there is no studies to support this. So the conclusion of the author was not to ever take this herb even for mild depression? A round about way of saying "Herbs are bad"? Over the counter pain medications are sold every year and many times do not help pain or people get known problems such as bleeding ulcers or rebound migraines. Yet we dont tell people to stop taking all over the counter pain medications. Isnt this the same rationale?

Posted by: Cherat51 | January 31, 2007 2:22 PM

Your advice not to take St.Johns Wort for for minor depression is not based on the evidence. there have been over 29 well conducted clinical trials in Europe comparing it to SSRI's and tricyclic's that show it to be as effective and in some cases more effective for minor and moderate depression with much fewer side effects. In Germany, it is prescribed more often that SSRI's 4 to 1. The pharmaceutical industry influence in the US. is obscene.

Posted by: zenman3 | March 20, 2010 6:27 PM

I'm wondering whether any legitimate studies have been done on the effects of SAM-e on depression and anxiety. I've been taking it for several years, and it seems to help with both. But I'm not certain.

Posted by: robinsonsb | March 27, 2010 10:23 AM

I'm wondering whether any legitimate studies have been done on the effects of SAM-e on depression and anxiety. I've been taking it for several years, and it seems to help with both. But I'm not certain.

Posted by: robinsonsb | March 27, 2010 10:23 AM

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