Popular Herb Works for Obsessive-Compulsive Disorder
The treatment was well tolerated. Three patients reported diarrhea and two reported restless sleep. One patient left the trial early because of a rash. Interestingly, "this treatment appears less effective for people who fail to respond to ... SSRIs," Kobak tells WebMD.
"It's neat that some other things other than standard medications are popping up that might be helpful," says Michael Jenike, MD, of Harvard Medical School, noting that about one-third of patients do not respond well to currently available medications.
In his experience, Jenike has had patients with obsessive-compulsive disorder who have used St. John's wort. "I haven't seen any dramatic successes, but most of the people I use it for are sicker patients who have failed other drugs. In their study, the ones that had already failed other drugs do not do very well." Jenike is also the director of the scientific advisory board of the Obsessive-Compulsive Foundation, which supported this study.
He adds: "People may ask, 'Why not use [St. John's wort], since it probably has fewer side effects, [and] is safer and less difficult to take than SSRIs?' My answer is that this report is really the only evidence that we have that St. John's wort might do anything [for obsessive-compulsive disorder]. The other drugs have been carefully studied, so they would still be the [drugs to choose]. But if this shows [in larger studies] it works as well as the other drugs, people might eventually pick St. John's wort over the SSRIs."
Patients sometimes take herbal compounds in addition to prescribed medications, and often without their physicians' knowledge, says Kobak. He urges patients to proceed with caution, because issues such as standardization of medications, contraindications, and drug interactions have not yet been well examined for many herbal medicines. He adds that there is also little information about any interactions between St. John's wort and other medications. "At a minimum," Kobak tells WebMD, "always let your physician know you are taking any herbal compounds."