Am I worried about the latest "finding" that the herb St John's wort — commonly used to treat mild depression — is useless? Far from it: I shall happily continue recommending it to patients. There have been countless clinical trials on the herb's effectiveness and safety, and the jury has considered and reconsidered the evidence many times.
Add to them the recent report that clinicians at Global Neuroscience Initiative Foundation, a mental-health charity, are unimpressed with St John's wort, preferring other herbs, including passion flower, for depression and anxiety.
Having worked in complementary medicine for many years, I know of so many more studies that have found St John's wort to be effective and well-tolerated.
Meaningful conclusion
The new report is just one study. I much prefer to draw my conclusions from systematic reviews, in which scientists bring together many studies (perhaps 50) and compare the body of evidence; this has much more meaning than a one-off study.
What shows up in these reviews is that this herb is as effective in treating mild to moderate depression as any of the pharmaceutical medications such as SSRIs (selective serotonin reuptake inhibitors).
I am not talking about using the herb in major depressions where the patient is suicidal or a danger to others, nor am I talking about day-to-day blues. "Mild to moderate" depression can be debilitating and life-changing in a negative way.
I will continue recommending this herb because it's well-tolerated, with patients seeing fast results, with few side-effects and fewer withdrawal symptoms.
Many patients on antidepressants struggle with nausea, insomnia and weight gain. When it's time to stop, they face headaches and cravings.
One of the most worrying aspects of the latest report is that potential users will either be put off taking St John's wort or assume it's no more harmful than a placebo and become cavalier with it, buying it in the supermarket or online. I would urge caution. If you are feeling low on a regular basis, perhaps irritable, moody, suffering insomnia and losing or gaining weight (all typical symptoms of depression), see your doctor first.
Get a proper diagnosis before you choose treatment methods. Then if "mild to moderate" depression is diagnosed, try St John's wort. Some doctors will even prescribe it. Best results come with long-term, daily use, usually at least six months. If it doesn't work, with your doctor's guidance, you can try an SSRI or another antidepressant.
St John's wort is not a harmless herb; it's a powerful medicine. But, taken responsibly, most people will see good results, which is a cheering thought.
