- 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 in 2000 and 2001 found that St. John's wort was no more effective than a placebo for treating major depression.
Thus, the authors recommend that people with major depression not take St. John's wort until well-designed studies support its use. People with mild to moderate depression would be wise to follow the same advice and not take St. John's wort.
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. Kava should not be used if you are pregnant, breast feeding, or taking antidepressants.
