THE HERBAL DEBATE

Examines the effectiveness of the herbal supplement Saint John's wort for the treatment of depression. Announcement made by the Council for Responsible Nutrition on the effectiveness of the herbal supplement for the treatment of mild to moderate depression; Results of a study which focused on the inability of the herb to relieve severe symptoms of major depression; Other studies which investigated the beneficial and negative effects of Saint John's wort.

By Kelly McCarthy, published on September 01, 2001

TREATMENT

FOR YEARS EUROPEANS HAVE TOUTED the herbal supplement St. John's wort as an effective treatment for depression, while many Americans have waited impatiently for the FDA's go-ahead. Now, a number of recent studies may have inched open the door for the herbal remedy in the U.S.

After reviewing more than 30 clinical trials on St. John's wort, the Council for Responsible Nutrition (CRN) declared that the herbal happy pill is "safe and beneficial for mild to moderate depression, stress and anxiety." A CRN panel of medical and scientific experts, who recently made the announcement at a Washington, D.C., press conference, also warned against taking the results of a soon-to-be released study too seriously. This study, conducted by the National Institutes of Health (NIH), focuses on only the herb's inability to relieve severe symptoms of major depression.

Initially, the NIH planned to study patients showing mild and moderate symptoms of depression, but then shifted its focus to severe symptoms for reasons that remain unclear. Regardless, CRN panel member Jerry Cott, Ph.D., former chief of the Psychopharmacology Research Program at the National Institute of Mental Health, pointed out that "no one single trial can ever be considered definitive.

"The NIH patients studied will probably have a very poor response rate to St. John's wort," Cott said. "We have to weigh all the evidence together."

Earlier this year, another systematic review of existing literature on St. John's wort appeared in the journal Public Health Nutrition and reported varying results. Led by P. Murali Doraiswamy, Ph.D., associate professor of psychiatry and behavioral sciences at Duke University Medical Center, the study revealed a growing list of drugs that are rendered less effective when combined with the herb, including oral contraceptives and some heart medications.

However, Doraiswamy also found that there are more positive than negative studies published about St. John's wort, more money is being put toward researching the herb and related studies are now using rigorous testing standards. All good news for depression sufferers, particularly those who avoid prescription antidepressants because of their side effects.