Posted by Larry Hoover on December 14, 2004, at 14:03:29
In reply to St. John's Question (please do not redirect), posted by Dan Perkins on December 13, 2004, at 20:43:34
> I know that this post technically belongs on the Alternative page, but I specifically want to ask this question to this group of people who, I feel, have a lot of knowledge and experience with traditional antidepressant medications.
>
> Have any of you tried St. John's Wart? I have been on the full range of antidepressants and there aren't many traditional meds left for me to try. I am curious if anyone here thinks that St. John's Wart is worth a try.Yes, I think St. John's wort is worth a try. It works by multiple mechanisms, including having a unique ability to inhibit all neurotransmitter reuptake pumps. Its MAOI activity has been exaggerated, but it does have a mild effect on that enzyme.
What's important is: a) that you get a quality product, as herbal products are not regulated in North America; b) that you do not limit yourself to the "standard dose" of 900 mg/day, standardized on hypericin.
If you do a trial as you would with any other antidepressant, i.e. gradually titrate the dose upwards until either a) remission occurs; or, b) side effects become intolerable, you will have appropriately tested the herb's effects.
There is no known overdose of SJW. Most common side effects are stomach problems and headache, but symptomatic treatment of those is fine. They tend to pass after a short time.
No antidepressant has given me better results than SJW did. Your brain may vary.
You will note in the following study that participants had severe depression, and they were dosed at 1800 mg/day of LI 160 (marketed as Kira in the US). Response was similar to imipramine, but the SJW was better tolerated. Another good brand to consider is Perika.
Pharmacopsychiatry. 1997 Sep;30 Suppl 2:81-5.
Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10.
Vorbach EU, Arnoldt KH, Hubner WD.
Department of Psychiatry and Psychotherapy, Ev. Krankenhaus Elisabethenstift, Darmstadt, Germany.
The special extract of St. John's wort, LI 160, exhibited a superior antidepressant efficacy compared to placebo in several controlled trials. Two further trials demonstrated a similar reduction of depressive symptomatology under LI 160 compared to tricyclics. All these trials were performed in mildly to moderately depressed patients. The present investigation was a randomized, controlled, multicentre, 6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in severely depressed patients according to ICD-10. The main efficacy parameter, a reduction of the total score of the Hamilton Depression Scale, proved both treatment regimens very effective at the end of the 6 week treatment period (mean values 25.3 to 14.5 in the LI 160 group and 26.1 to 13.6 in the imipramine group), but not statistically equivalent within a a-priori defined 25% interval of deviation. The analysis of subgroups with more than a 33% and 50% reduction of the HAMD total score justified the assumption of equivalence within a 25% deviation interval. This view was also supported by the global efficacy ratings from patients and investigators. Regarding adverse events, the nonrejection of the nonequivalence hypothesis denotes a superiority of the herbal antidepressant. These main result indicate that LI 160 might be a treatment alternative to the synthetic tricyclic antidepressant imipramine in the majority of severe forms of depressions. However, more studies of this type must be performed before a stronger recommendation can be made.
Lar
poster:Larry Hoover
thread:429151
URL: http://www.dr-bob.org/babble/alter/20041212/msgs/429508.html