St. John's Wort and SAM-e: The Mood Menders

Sometimes, you can't sleep, and others, you can't drag yourself out of bed.Life seems pointless and empty; your emotions are erratic and uncontrollable. That's the way more than 19 million Americans will feel this year when they experience a depressive disorder, according to the National Institute of Mental Health. So it's no wonder that many people are seeking out dietary supplements used to treat mild to moderate depression--especially St. John's Wort and SAM-e.

Just this winter, a German study of 268 people reported the groundbreaking news that St. John's Wort, or Hypericum perforatum, is at least as effective as imipramine (trade name Tofranil), a prescription antidepressant, at relieving moderate depression. In the study, published in the British Medical Journal, subjects given 350 mg of hypericum extract three times a day reported relief of depressive symptoms and experienced fewer side effects than subjects taking the prescription drug.

Scientists still aren't sure how the plant works, but they think that it may elevate mood by altering brain levels of feel-good neurotransmitters such as norepinephrine, serotonin and dopamine. Ray Sahelian, M.D., a nutritionist in Marina Del Ray, California, suggests that people with low mood start with one pill of St. John's Wort per day and then decide if they need more, since larger amounts may cause insomnia or sun sensitivity.

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A newer, highly touted natural antidepressant is SAM-e, or S-adenosyl-L-methionine. Our body synthesizes the substance from methionine, an amino acid, and adenosine triphosphate, a molecular energy source, but our normal stores of the substance seem to dissipate when our mood suffers.

"There's a correlation between low levels of SAM-e and depression," says Richard Brown, M.D., associate professor of psychiatry at Columbia University and co-author of Stop Depression Now (G.P. Putnam and Sons, 1999). SAM-e, which has only been available on drugstore shelves for a year, seems to relieve depression by boosting brain levels of serotonin and dopamine. A 1994 Italian survey of research on the supplement suggested that it worked as well as standard prescription antidepressants and had few side effects, and a 1992 Mexican study concluded that SAM-e enhanced the blues-lifting effect of a prescription antidepressant on patients.

SAM-e may also be an important supplement for the elderly, even those with high spirits. The supplement can repair tissue throughout the body, especially in the liver and around the damaged joints that cause arthritis, relieving both pain and inflammation.

A caveat: When thinking about using SAM-e or St. John's Wort for low mood, don't forget that depression can be a very serious illness. "If one has a mild case, then self-therapy is fine," says Sahelian, author of The New Memory Boosters (St. Martin's Press, 2000). "But anything more serious should be evaluated by a professional."

PHOTO (COLOR): SAM-e can beat the blues and relieve the pain associated with arthritis.

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