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The Irish Times has an article on St John’s Wort. St John’s Wort is a herbal remedy that has been quite popular in the treatment of depression. Interestingly, in some countries, for example Ireland and Germany, preparations of St John’s Wort are prescribed by Doctors to treat mild depression. In Germany, St John’s Wort extracts are prescribed more than other anti-depressant medications.

A recent review found that extracts of St John’s Wort were effective in treating major depression, having similar efficacy to standard antidepressants. There were also indications that St John’s Wort has fewer side effects. However, the authors noted there was a difference in the results from studies from German and Non-German speaking countries, which could mean some studies from German speaking countries were overoptimistic. Alternatively, it could be due to better administration of St John’s Wort in German speaking countries.

The mechanism by which St John’s Wort has this effect is currently unknown. There is some indication that some components – hyperforin and hypericin – may block serotonin re uptake, achieving a similar effect to conventional SSRIs. However, an extract of St John’s Wort without hyperforin still has antidepressant effects. St John’s Wort contains a number of different compounds, and this makes it difficult to establish which compounds are responsible for it’s effects.

It should be noted that St John’s Wort interacts with many drugs. For example, St John’s Wort can cause Serotonin Syndrome when taken with other antidepressants, presumably because both effect Serotonin. Also, St John’s Wort can interact with drugs that act on different parts of the body. This occurs when drug metabolism is altered – St John’s Wort can increase the rate which the body processes the drug, and so decrease the amount of active drug left in the body. For example, St John’s Wort can cause oral contraceptives to be ineffective. (A list of interactions is on wikipedia). For this reason, it is recommended that St John’s Wort should be only be taken after consultation with your Doctor.

So, St John’s Wort is a herbal antidepressant that can be effective in treating depression, and with less side effects. However, as with most medications, it is not advisable to take St John’s Wort without consulting your Doctor -especially if you are on other medications.

I came across an interesting article today, reviewing a book called ‘Listening to Depression’. The premise of the book is to not treat Depression as a problem in your life, but as reaction to problems in your life. The article uses the analogy of a warning light coming on when a plane drifts off course, to let the pilot know to make some changes to get back on course. So the experience of  depression is our brain’s way of letting us know that something is not right.

The analogy of a warning light is good, as it reminds us what to focus on. Sometimes we focus so much on the symptoms of depression, and forget about dealing with the underlying issues. It can be worthwhile to take a step back and stop focusing on the ‘warning light’, and look at what is setting the ‘warning light’ off in the first place.

The article has an exercise you can go through to try and explore what has set off your ‘warning light’, which I’ve copied here so you can try it:

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July 2009