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St. John’s Wort for Major Depression?

German Study Shows Herb as Effective as Antidepressants for Major Depression

Quality of St. John's Wort Varies

Scientists are still not sure how St. John's wort works for depression. The authors of this study write that at least seven ingredients may be involved.

According to the researchers, studies from German-speaking countries appear to have better results from taking St. John's wort for depression. They note that St. John's wort has a long tradition of use in these countries, and the "difference could be due to the inclusion of patients with slightly different types of depression, but it cannot be ruled out that some smaller studies from German-speaking countries were flawed and reported over-optimistic results."

The authors write that the quality of St. John's wort "can differ considerably."

They note that a recent study of what is available on German store shelves found that a number of brands contain only a tiny amount of the main active ingredients thought to be key for treating depression.

Power of Placebo

Linde says in a news release that those products with very low concentrations may only work by a placebo effect.

Raison says a placebo can be a "very powerful antidepressant."

"There's a whole body of literature now that shows placebo can have a direct effect on the pathways of the brain and work like an antidepressant."

Timing of Antidepressants

How long do traditional antidepressants take to kick in?

The old thinking was that you wanted to see depression lift within four to six weeks, but Raison says that is changing. "You want to see within a week or two that patients are getting better."

Why?

According to Raison, one reason is that the "longer it takes [a traditional antidepressant] to work, the more vulnerable people are to have a relapse."

The review and findings are published in The Cochrane Library.

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