Is St John’s Wort Actually Effective for Depression?

Depression affects far more people than you can imagine. More than 400 million people in the world are affected by this silent mental illness. One should not take depression light, as it can be a serious mood disorder. Depression causes severe symptoms that impact each and every aspect of your life. It can start interfering with your day-to-day life and even affect simple activities such as eating, sleeping, working, etc. There are many medications that are effective in treating depression, but they are also known to have serious side effects. Due to this, many people prefer using alternative or natural remedies for depression. St. John’s wort is one such medical plant that has been used for many years now for the treatment of depression and many other conditions as well. But how viable is using St. John’s wort to fight depression? Let us look at whether scientific evidence supports this theory or not.

Is St John's Wort Actually Effective for Depression?

Is St John’s Wort Actually Effective For Depression?

The flowers and buds of St. John’s plant are usually dried and made into capsules that are used as supplements. They can also be pressed to be used as oils and other liquid extracts. It is also possible to apply St. John’s wart directly onto the skin in its oil form. St. John’s wort has been used widely for treating depression and other conditions such as sleep problems, anxiety, as well as seasonal affective disorder. But does the herb really work?

It is believed that St. John’s wort works in a similar manner such as selective serotonin reuptake inhibitors, commonly known as SSRIs, antidepressants. SSRIs make your brain feel all the good emotions by releasing the ‘feel-good’ hormones in the body. These include:

  • Dopamine
  • Serotonin
  • Norepinephrine

All these chemicals regulate our moods. Therefore, the more amount of these chemicals you have in your body, the better are your chances of fighting off depression and keeping it at bay.

What Does Science Say?

While there is some scientific evidence that shows that St. John’s wort may actually be helpful in treating moderate to mild depression, there are also studies that show that the herb is no more effective than a placebo in treating cases of major depression.

In Germany, a study conducted by a firm that actually manufactures St. John’s wort extract found that consuming high-quality and pure St. John’s wort can actually be effective in treating depression – similar to the prescribed antidepressants. The study, sponsored in part by the German manufacturer of St. John’s wort, Schwabe, reviewed 29 trials of the herb across 5,489 participants. These participants, all adults, were suffering from severe depression. They were randomly assigned a placebo, or a prescription antidepressant, or St. John’s wort. The researchers and the participants were both kept in the dark about which was getting which treatment during the duration of the trials.

The results showed that in at least nine trials, people who were on St. John’s wort and those who were taking the prescription antidepressant for a period of 4 to 12 weeks, had the same outcomes with regards to how much better they felt after the treatment. Thus, the researchers concluded that St. John’s wort was more effective than your regular placebo. It was also observed that the participants who took St. John’s wort suffered from lesser side effects as compared to the standard-issue prescription antidepressant.

Meanwhile, though, in the United States, the jury is still out on just how effective St. John’s wort is at treating depression. The studies conducted in the US have had a mixed set of results. Let’s take a look at some of them:

In 2016, A Review Of 35 Studies Determined The Following:

  • St. John’s wort was more effective at reducing symptoms of moderate depression as compared to a placebo
  • The herb reduced the symptoms of depression to the same extent as prescription antidepressants
  • There appeared to have been lesser side effects of St. John’s wort as compared to prescription antidepressants

In 2011, a 12-week clinical trial was conducted by the NCCIH and NIMH with 73 people. The study gave the participants St. John’s wort or a standard antidepressant called citalopram. The study concluded that neither the herb nor the antidepressant actually lowered the symptoms of mild to moderate depression as compared to a placebo.

In 2012, NIMH and NCCIH again funded a 26-week clinical trial with 124 participants. The participants were given either St. John’s wort or sertraline, a standard antidepressant, or a placebo. The study concluded that the results were the same and St. John’s wort, the antidepressant, and the placebo all were equally effective in treating moderate depression.

Coming to a 2008 review of nearly 30 international studies, it showed that St. John’s wort worked better than a placebo and was equally as effective as any other prescription antidepressants that are used for treating moderate to mild depression. The study showed that St. John’s wort also has much fewer side effects as compared to the antidepressants.

In 2002, another NCCIH and NIMH study determined that St. John’s wort is no more or no less effective than a placebo for treating mild to moderate depression. Therefore, as can be seen, the scientific evidence appears to be mixed when it comes to determining the actual effectiveness of the herb.

Conclusion

It is safe to say that more rigorous studies are required to understand the effectiveness of St. John’s wort in cases of all types of depression. However, data to date suggests that the herb is safe and well tolerated by depression patients. It is also safe to assume that St. John’s wort is more effective in treating depression than a placebo. However, this only holds true in cases of mild to moderate depression. More data is required to assess the use of the herb in severe depression and also compare its efficacy with other prescription antidepressants.

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References

  1. Shelton, R.C., Keller, M.B., Gelenberg, A., Dunner, D.L., Hirschfeld, R., Thase, M.E., Russell, J., Lydiard, R.B., Crits-Christoph, P., Gallop, R. and Todd, L., 2001. Effectiveness of St John’s wort in major depression: a randomized controlled trial. Jama, 285(15), pp.1978-1986.
  2. Szegedi, A., Kohnen, R., Dienel, A. and Kieser, M., 2005. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John’s wort): randomised controlled double blind non-inferiority trial versus paroxetine. Bmj, 330(7490), p.503.
  3. Hypericum Depression Trial Study Group, 2002. Effect of Hypericum perforatum (St John’s wort) in major depressive disorder: a randomized controlled trial. Jama, 287(14), pp.1807-1814.
  4. Woelk, H., 2000. Comparison of St John’s wort and imipramine for treating depression: randomised controlled trial. Bmj, 321(7260), pp.536-539.
  5. Gaster, B. and Holroyd, J., 2000. St John’s wort for depression: a systematic review. Archives of Internal Medicine, 160(2), pp.152-156.

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