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Home > Anti-aging Research Antidepressants > St. John's Wort

St. John's Wort (Hypericum perforatum)

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CME/CEM:

  • Depression Management - ContinuingEducation.com, exp. 12/31/02 - see "St. John's Wort (SJW)" about three forth the way down the page.

Ze 117 Extract (Not available in the US, Remotiv brand in Germany):

LI 160 Extract (Kira® Brand LI-160 extract in the US, Jarsin 300 brand in Germany):

WS 5572 Extract (Perika Brand in US, Neuroplant 300 brand in Germany):

WS 5570 Extract (contains at least 4% hyperforin but I don't believe it's available)/(Perika Brand  in US, Neuroplant 300 brand in Germany):

STW3-VI Extract:

Other News:

I'm not a doctor and what I write should not be taken as medical advice. With that said, I should be able to talk about what I've read without being sued for medical malpractice.  (Isn't there something in the First Amendment?).

The more I read about St. John's wort, the more I'm convinced that it the best anti-depressant on the market - prescription or non-prescription. St. John's has several advantages over other anti-depressants. For one thing, it increases all three of the brains primary nero-transmitters - serotonin, norepinephrine and dopamine (dopamine and norepinephrine are aphrodisiacs, norepinephrine is associated with increased energy). The only other anti-depressant that does that is Effexor, but it is week on norepinephrine and dopamine. One of the things that used to worry me about St. John's wort was that most of the studies were done comparing it to imipramine and I didn't believe that imipramine was a very good anti-depressant because it is seldom used. After doing more research, I discovered that imipramine is one of the most effective anti-depressants available but most people prefer other anti-depressants because of the severe side effects of imipramine.

There is a new anti-depressant called reboxetine, which is made by Upjohn and sold in Europe and awaiting FDA approval in the US. In trials, patients on reboxetine and imipramine had mean Hamilton scores of 1.1 while patients on fluoxetine (Prozac) had a mean score of 2.6 and patients on placebo had a score of 4.7 (Severe depression responds to new class of antidepressants - Reuters, 6/9/98). What that shows is that both reboxetine and imipramine are nearly identical in effectiveness and are more than twice as effective as Prozac. The advantage of reboxetine over imipramine is that it has much less side effects than imipramine. Yet, in every study comparing imipramine and St. John's wort, the difference in the results was negligible. Plus, St. John's wort has far less side effects.

There are several other advantages to St. John's wort. It is a mild inhibitor of both MAO-A and MAO-B. St. John's wort also inhibits the action of interleukin-6, a cytokine that may contribute to the increased cortisol production noted in major depression.

St. John's wort has anti-viral and anti-bacterial properties. It also contains carotenoids, flavonoids and beta-sitosterol which have been associated with decreased cancer and anti-oxidant effects. It contains proanthocyanidins which is the same compound at Pycnogenol (20 times more powerful than vitamin C and 50 times more so than vitamin E).

I read articles claiming that St. John's wort is only for mild to moderate depression. I guess they say that because there is only one trial that I know of where is has used for severe depression.  In that trial, St. John's wort compared quit favorably with imipramine (one of the most effective anti-depressants available).

St. John's wort has been used in trials up to 3600 mg per day.  It seems like in all the studies, they used 300 mg of St. John's wort as the equivalent of 25 mg of imipramine.  If you use the Vorbach/Arnoldt 1997 study and assume a linear relationship, I calculate that you need 12.5% more St. John's wort and come up with 2700 mg of St. John's wort should equal 200 mg of imipramine (the amount of imipramine used for severe depression).  Again, you should always do things in conjunction with as physician.  One reason is that there is the concern over serotonin syndrome which can be fatal.

Ben


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