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Sam-e versus St-John's wort as a treatment for depression

Although promoted as an alternative therapy for depression, the herbal supplement St. John's wort (Hypericum perforatum) appears to be ineffective for people with severe clinical depression.
depression and st-john's wort

According to the 1st large study (1,2) to evaluate it in the U. S., the popular herbal remedy St. John's wort is useless for alleviating severe depression.

The study, which tested St. John's wort for 8 weeks among 200 patients whose depression made it hard for them to get out of bed in the morning or look after their children, found that St. John's wort was no better than a placebo.

The study forces us to question the effectiveness of St. John's wort, which has been marketed as an effective and safe alternative to prescription antidepressants. About 2 dozen previous studies found St. John's wort effective for depression, mostly in mild to moderate cases.

Far from settling what has long been a subject of contention, this study is likely to spur greater controversy between practitioners of alternative and mainstream medicine.

In another, more recent study (3) of 340 patients diagnosed with moderate depression, St. John's wort proved no more effective than placebo in alleviating depression symptoms. Active treatment with the antidepressant drug Zoloft worked somewhat better than placebo.

There is a body of evidence which suggests that St. John's wort (Hypericum perforatum), used for more than 2,000 years to help with mood problems, does help symptoms of depression. In Germany, where many of the positive studies on St. John's wort have been conducted, St. John's wort is available as a prescription antidepressant.

But the quality of much of this research has been criticized - including the lack of studies using a placebo and an SSRI (selective serotonin reuptake inhibitor) such as Paxil or Zoloft, according to the authors of this new study. SSRIs are a newer class of drugs commonly used to treat depression - they are HOWEVER associated with numerous side-effects. In a future article, I will discuss in particular Paxil and "Paxil withdrawal", which makes it difficult for someone taking the antidepressant Paxil, to quit, in spite of the drug manufacturer's claims that Paxil is "non-habit forming".

To address these concerns about earlier St. John's wort studies, researchers assigned patients to take St. John's wort, Zoloft or placebo for up to 26 weeks.

At the end of the study, the researchers found that neither St. John's wort nor the depression drug was better than placebo in improving patients' scores on a standard scale of depressive symptoms. Overall, nearly 33% of placebo patients showed a full response to treatment, compared with roughly 24% in both the St. John's wort and Zoloft groups.

I suspect that St. John's wort does work for some people, and that like many antidepressants, it does not work for many others. However it is worth nothing that there have been reports that St. John's wort could also interfere with sensitivity to sunlight, cardiac drugs, AIDS medicines and oral contraceptives.


SAM-E for depression

There is a better alternative. I have a long family history of depression, and I can tell you that I have obtained my best results by far with a supplement called SAM-E (S-adenosylmethionine). A more detailed discussion of SAM-E can be found here.

SAM-E has been sold in Europe for over 20 years as a prescription drug for depression.

It's important that you as a consumer know the actual amount of SAM-E in the product which you are purchasing for both the therapeutic value of the product and for price comparison. It is also important to purchase ENTERIC-COATED tablets so that the SAM-E is less likely to break down in your stomach, prior to reaching the intestine where SAM-E is primarily absorbed.

SAM-E is sold in many forms, containing an additional compound which is attached to the SAM-E molecule, for the purpose of stabilizing the SAM-E molecule and preventing degradation. In all of these forms, an additional compound is attached the SAM-E molecule. The names of these stabilizing compounds include tosylate, disulfate tosylate, disulfate ditosylate, and 1,4-butanedisulfonate and are typically written immediately after the chemical name of SAM-E. It is important for consumers to know that these stabilizing compounds can weigh at much as the SAM-E molecule itself.

Some inaccurately labeled products combine the weight of the stabilizing compound with the weight of the "free" SAM-E. As an example of this, consider that a product claiming to have 200 mg. SAM-E may in fact contain only 100 mg. "free" SAM-E and 100 mg. of the stabilizing compound.

Consequently, a tablet containing 200 mg of S-adenosyl-methionine disulfate tosylate will contain only 100 mg of SAM-E. Most, but not all labels, make this clear. So look at the label carefully.

A complete discussion of SAM-E can be found here.



Buy my wristband/intranasal full spectrum light device. Made by hand by myself.



(1) Washington Post April 18, 2001; Page A02

(2) Journal of the American Medical Association 2001; 285: 1976-1986

(3) JAMA April 10, 2002;287:1807-1814, 1853-1854



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2003 Healing Daily