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{7} october 4, 2009

Health debate




THERE IS CONSIDERABLE DEBATE around the use of the yellow flowered herb known as St John’s wort in the treatment of depression. It may make you feel better to think that what you are taking is “herbal” and therefore more natural, but it is not a risk-free option. While it may be beneficial for some cases of mild depression, it is unlikely to be effective for more serious biological depression, and side effects can include dry mouth, dizziness, increased sensitivity to sunlight, tiredness and gastrointestinal problems. There is also the possibility of adverse interactions with other medications, such as heart medications, anti-epileptics, the oral contraceptive pill, anti-migraine medicines, warfarin, THE DOCTOR transplant drugs, HIV medications and other antidepressants. The strength of the active ingredients may vary between Dr Cindy Pan different preparations and batches, so the dose of active compounds you are taking each time cannot be precisely controlled. And if your depression is more severe and St John’s wort isn’t enough to manage it, you may delay instituting more effective treatment, with all the inherent risks, mental anguish and emotional suffering that poorly managed depression entails. Even if St John’s wort does work, it may take up to four weeks to become effective. There is less known about St John’s wort in terms of safety and efficacy and, given the variable quality and potency of different formulations, finding the correct dosage may be challenging. Even in studies where St John’s wort was found to be more effective than a placebo in treating mild depression, it was still no more effective than standard antidepressants. So even in mild cases where St John’s wort might be a viable alternative, it is not necessarily a better one. ■ Dr Cindy Pan has had over 10 years of clinical practice. Her books include Pandora’s Box: Lifting The Lid On Life’s Little Nasties (HarperCollins) and Playing Hard To Get (HarperCollins). She appears on television, lectures and speaks about all aspects of health, relationships and wellbeing.

ELLA BACHÉ ST JOHN’S WORT, otherwise known as hypericum perforatum, has been used medicinally since ancient Greek times. It has enjoyed its greatest popularity in Europe and comprises 25 per cent of all antidepressant prescriptions in Germany. This strong historical and current evidence suggests there has to be something to this yellow flowering plant. As with all herbal preparations, the quality determines the outcome. Just as you can’t compare cask wine with exclusive wine, neither can you compare any old product with some of the standardised, carefully processed and well manufactured products available to qualified herbalists. St John’s wort can only be THE NATUROPATH considered a viable alternative if the quality of the an product is guaranteed. Quality extracts have been tm ch He ah Le shown to be a successful treatment for mild to moderate depression in numerous double-blind, placebo-controlled studies, and this has also been confirmed by multiple meta-analyses. A recent Cochrane review analysed data from over 37 of these studies and found hypericum extracts improved symptoms more than a placebo, and produced effects similar to synthetic antidepressants. This means that for mild to moderate depression, it is very successful when the right prescription is used. However, if depression is moderate to severe, I wouldn’t wait for the St John’s wort to kick in. I would suggest you see your doctor promptly and consider antidepressants. Herbal medicines have their place in medicine, but a realistic approach is essential.


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■ Leah Hechtman is a naturopath and fertility specialist. She is a lecturer, author, researcher and industry consultant and has her own clinical practice in Sydney, NSW. She specialises in fertility, reproductive and psychological health. For more information visit AVAILABLE AT ALL STORES TSD7519/BS

St John's Wort and Depression  
St John's Wort and Depression  

THE DOCTOR THERE IS CONSIDERABLE DEBATE Receive your BONUS * summer tote including two suncare products, when you spend $100 or more ^ on El...