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St John's wort (Hypericum perforatum) is a natural herb that is available over the counter treatment for the treatment of mild depression; 12% of Americans report using it at least once a year. St. John's wort has action similar to antidepressants, including monoamine oxidase inhibition, serotonin reuptake inhibition, and actions on sigma receptors. St. John's wort has been shown to be better than placebo in some earlier controlled studies and equally effective as tricyclic antidepressants in the treatment of depression. However, most of these earlier studies were poorly controlled and did not use standard definitions of depression, making it difficult to draw conclusions about the efficacy of St. John's wort. More recently there have been several large controlled trials as well as meta-analyses that have provided information about the efficacy of St. John's wort. A large placebo controlled randomized trial using appropriate methodology in patients with severe cases of major depression showed no difference between St. John's wort and placebo (1). However a direct head-to-head comparison of St. John's wort to the SSRI paroxetine showed it was better in reducing symptoms of depression in patients with severe major depression; 71% of St. John's wort treated patients had a 50% reduction in symptoms compared to 60% on paroxetine (2). Headache was the only side effect with St. John's wort that was more common than placebo. A second study funded by the NIH and performed by the Hypericum Depression Trial Study Group (HDTSG) showed that St. John's wort was not more effective than placebo, but not worse than an antidepressant comparison (3). Response was 32% for placebo, 25% for sertraline and 24% for St John's wort. St John's wort caused an increase in swelling, frequent urination and sexual dysfunction, while sertraline caused diarrhea, nausea, sexual dysfunction, forgetfulness, frequent urination, and sweating, more than placebo. My recommendation is if you want to try St John's wort for depression, that it is OK to try. You may get some help and avoid the hassle of going to the doctor, and the potential risks and side effects are low. 1.Shelton, R.C., Keller, M.B., Gelenberg, A., Dunner, D.L., Hirschfeld, R., Thase, M.E., Russell, J., Lydiard, R.B., Crits-Cristoph, P., Gallop, R., Todd, L., Hellerstein, D., Goodnick, P., Keitner, G., Stahl, S.M., Halbreich, U. Effectiveness of St John's Wort in major depression: A randomized controlled trial. Journal of the American Medical Association. 2001;285(15):1978-1986. 2.Szegedi, A., Kohnen, R., Dienel, A., Kieser, M. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St. John's wort): Randomised controlled double blind non-inferiority trial versus paroxetine. British Medical Journal. 2005;330:503-508. 3.HDTSG. Hypericum Depression Trial Study Group: Effect of Hypericum perforatum (St Joh's Wort) in major depressive disorder: A randomized controlled trial. Journal of the American Medical

Association. 2002;287(14):1807-1814.

J. Douglas Bremner, MD, is a researcher and physician and author of 'Before You Take That Pill: Why the Drug Industry May be Bad for Your Health: Risks and Side Effects You Won't Find on the Label of Commonly Prescribed Drugs, Vitamins and Supplements.'

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==== ==== Discover the amazing properties of St. John's Wort Today. Sale On Now Get 20% off using coupon code 'pdf20' ==== ====

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