When I was taught about Hypericum perforatum in my naturopathic training, I was told that it is indicated for depression. This is relatively common knowledge. I was also taught that it helps relieve some other conditions associated with the nervous system such as anxiety and insomnia.
This was unsurprising. I had tried the herb before, in my youth, and experienced some of its effects. I had it as a strong infusion one afternoon, wondering whether it would produce some sort of bonus boost to my generally non-depressed status. The sort of thing that curious folk do. That night I slept more soundly than usual and woke up very refreshed. So I gathered that it is also relaxing and promotes sleep, even though it did not say so on the packet.
It is very cool to get confirmation about my past observations. What was not cool though, was thinking, for years, that it is not suitable for major depression when in fact it is. Have you heard people, including naturopaths, say that St John’s Wort is recommended only for mild to moderate depression? This is also, regretable, relatively common and very inaccurate knowledge.
According to traditional knowledge, St John’s is used to treat depression, full stop, not just mild to moderate. And now science has caught up with this claim. The latest, and best available evidence (a Cochrane review with meta-analyses), has shown that St. John’s wort extracts, tested in high-quality clinical trials, were superior to placebo and similarly effective as standard antidepressants. On top of this, they caused fewer side effects than standard antidepressants. The participants of the trials had to suffer major depression to be eligible. You can listen to a podcast of the review here, or read it here.
I think that the manner of side-effects of standard antidepressants is also relatively common knowledge. So if we are on the same page, then we can agree that they can be serious.
So what is stopping medical professionals from preferring them over standard antidepressants? Now that’s the subject of a whole other blog post, (perhaps that somebody else can write).
Now there are various things to consider. Cautions that must be taken when taking this awesome herb. One issue is drug interactions. There are several. Especially when combined with other psychiatric drugs and other seemingly unrelated drugs such as the oral contraceptive pill.
Other very important issues are the quality of the herb the type of extract, and dosage. Not every St. John’s Wort product available on the retail shelf is up to scratch. In fact, many come nowhere near the quality of the extracts investigated in the Cochrane review.