Depression: Treatment, Causes and Diagnosis |
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St Johns WortSt John’s wort as a depression treatment
• What is St John’s wort? What is St John's wort? St John’s wort (Hypericum perforatum) is a perennial herb with a yellow flower that has been used to treat nervous conditions since ancient Greek times.Today, it is a popular herbal remedy for depression. The plant has many chemical compounds, some of which are believed to help depression by preventing nerve cells in the brain from reabsorbing the chemical messenger serotonin, or by reducing levels of a protein involved in the body's immune system functioning. Most preparations have been standardized to include the main active ingredients of hypericin and hyperforin. It’s important to note that while St John’s wort is a herb, it is still an active treatment that has specific chemical effects. Is St John’s wort effective as a depression treatment? There have been many clinical studies comparing the effectiveness of St John’s wort with placebos and antidepressant medication. Most have found the herbal remedy to be superior to placebo and equivalent to standard antidepressants for the treatment of mild to moderate depression. However, for the treatment of melancholic (biological) depression, it is unlikely to work. In general, St John’s wort has been recommended as a useful alternative for those not wanting to take antidepressant medication for the treatment of mild depression. What are the side-effects of St John’s wort? The use of St John’s wort as a treatment for depression has created some controversy, with clinical trials into its safety and effectiveness constantly under review. Generally, St John’s wort is well tolerated when taken on its own. The most common side-effects reported are dry mouth, dizziness, increased sensitivity to sunlight (photosensitivity), gastrointestinal symptoms and fatigue. Its safety in pregnancy has not been clarified. St John’s wort as a depression treatment is freely available world wide. Does St John’s wort affect other medications? St John’s wort is known to adversely interact with some medications. Taken in combination with other drugs, St John’s wort can boost the effect of the other drug, which then increases the risk of negative reactions. St John’s wort may also impact on the breakdown of other drugs by reducing concentration in the blood and hence their effect. Contraindications can occur with interactions between St John’s wort and antidepressants, HIV medications, transplant drugs, warfarin (a blood thinning agent), some heart medications, anticonvulsants used in the treatment of epilepsy, the contraceptive pill and migraine treatments. St John’s wort should not be used in conjunction with antidepressant medication. How does it work? It is thought that St John’s wort assists in the reuptake of serotonin, dopamine and noradrenaline, which are chemicals in the brain that are linked to depression and anxiety. Recent clinical trials have found that St John’s wort was superior to placebo, or as effective as standard antidepressants (for example, Prozac, Tofranil and Zoloft). Dosage It is suggested that 900 mg of St John’s wort is required to effectively reduce symptoms of non-melancholic depression. As with other antidepressant medication, the herbal remedy may take up to four weeks to become effective. Key points to remember • St John’s wort appears to be an effective treatment for mild (non-melancholic) depression. • It is not advisable to treat people with significant major depression with St John’s wort, given the risks associated with ineffective treatment. • Because of problems with adverse drug reactions, St John’s wort may not be suitable for everyone. • St John’s wort should not be taken in combination with other prescription drugs, including antidepressants. If you are taking other medication, always check with your General Practitioner first. Like to know more about non-pharmaceutical treatments of depression including StJohn's Wort?
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