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

Presents information on the therapeutic use of Saint John's Wort and S-adenosyl-L-methionine (SAM-e). Amount of Saint John's Wort taken three times a day reported to relieve depressive symptoms; Neurotransmitters enhanced by Saint John's Wort; Correlation between depression and SAM-e levels in the body.

By PT Staff, published on March 1, 2000 - last reviewed on January 23, 2015

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

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.

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

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.