6 Reasons for Consulting With your Doctor Before Taking St. John’s Wort

I was first diagnosed as having clinical depression ten years ago by a marriage counselor who recognized that I had reached a psychological state in which I felt that “things were getting steadily worse” and that I no longer enjoyed activities that I used to like to do. I was also having fits of temper which seemingly came out of nowhere and had problems with sleeping and memory loss.

The counselor sent me to a psychiatrist who immediately recognized the symptoms of clinical depression. He prescribed Prozac.

“You'll have to take this for at least a couple of weeks before you see any results,” he cautioned.

I was thankful for his cautionary advice - and not so thankful for the fact that he failed to tell me about the side effects of Prozac. While I began to feel more “peaceful”, my sexual libido instantaneously dropped to zero.

My wife “wanted her husband back”. Yes, somehow he had disappeared, to be replaced by a kind of detached Buddha with no sexual interest whatsoever.

I began to despair. Wasn't there a single antidepressant out there that didn't have moderate to serious side effects connected with it? I began to ask around, and a friend introduced me to St. John's Wort.

I noticed an immediate effect. My mental outlook drastically improved. I began to enjoy life again, and my fits of anger disappeared. And best of all, there were no side effects.

None that I could detect anyway.

Was this the panacea for depression, I wondered? The magical cure everyone could take without fear?

It has seemed that way for awhile…

SEROTONIN AND THE CHEMICAL SYNAPSE

Clinical depression has been traditionally attributed to a depletion of serotonin in the cells responsible for neural transmission, known as chemical synapses. These are gaps across which neurons signal each other, a process that involves serotonin, one of the three monoamine neurotransmitters in the nervous system. Neurotransmitters are synthesized by the presynaptic neural cell (the one that precedes the gap) to communicate with the post synaptic cell (which follows the gap).

It follows that once the neurotransmitter has been synthesized and accomplished its task of communication; it needs to be absorbed so that it won't go on stimulating the postsynaptic cell. This absorption is known as “uptake” or “reuptake”.

Three types of monoamine neurotransmitters have been identified: norepinephrine NE, dopamine DA, and serotonin 5- HT. A drop in the level of serotonin was usually identified with clinical depression and is caused by abnormal uptake. Recent research has been showing that the cause of depression may be considerably more complicated, involving the other neurotransmitters, hormones and the immune system.

Serotonin levels have been traditionally enhanced by the selective serotonin reuptake inhibitors (SSRI) such as Prozac.

MORE EFFECTIVE THAN SSRI'S?

For the past several years depression sufferers, along with the mainstream medical community, have increasingly recognized that St. John's Wort is effective in treating clinical depression.

Until recently, nobody knew how it worked.

In a recent study, St John's Wort has been shown to influence serotonin and noradrenaline in the forebrain of the limbic brain circuits, an area that controls mood. Researchers in the Department of Pharmacology at the University of Frankfurt in Germany have observed that St. John's Wort increases the effectiveness of norepinephrine, dopamine, L-glutamate, and gamma-amino butyric acid (GABA), as well as serotonin; in other words, it has a “broad uptake profile”.

In short, it may be more effective than the SSRI's.

REASON #1: SIDE EFFECTS - I THOUGHT IT DIDN'T HAVE ANY!

In double-blind studies, research in Missouri has shown that of the 43 people taking St. John's Wort, 84 per cent reported an improved mood, while 47 percent reported SSRI type side effects, such as

· mental confusion

· nausea

· cardiovascular and motor abnormalities

· food-drug interactions

· withdrawal symptoms

· depressive relapse

Of the twelve percent who discontinued use, 13 people experienced withdrawal symptoms, and 1 reported to the Emergency Room

REASON #2: SEROTONIN OVERLOAD

In addition, taking St. John's Wort concurrently with one of the SSRI's may result in a serotonin overload.

REASON #3: CONCURRENT DRUG LEVELS CAN BECOME DANGEROUSLY HIGH

Taking it with other drugs can reduce the drugs' effectiveness. St. John's Wort has been shown to activate a set of enzymes in the liver which is used to break down many substances.

One should not suddenly stop St. John's Wort if it is being taken with other drugs, because the drug level in the bloodstream can become dangerously elevated. The herb and the drug need to be carefully adjusted and balanced with the help of your physician.

REASON #4: SKIN SENSITIVITY

It has long been known that skin sensitivity to sunlight is a side effect of St. John's Wort. Just be careful about sun exposure. Use a lot of sun block, a hat, and a long sleeved shirt while in the sun.

REASON #5: MANIA AND BI POLAR SYNDROME

St John's Wort has been shown to trigger mania in people with bi-polar syndrome, and can result in psychosis, according to a recent study by researchers in Amsterdam.

REASON #6: PREGNANCY

So far no studies have been made to determine the effect of St. John's Wort on pregnancy. Until studies have been made, it seems only wise to avoid taking the herb during pregnancy.

THE GOOD NEWS AND THE BOTTOM LINE

The good news is that double-blind clinical studies have definitely established St. John's Wort as effective in alleviating mild to moderate clinical depression, and the side effects, for those who do experience them, are similar to SSRI's. Drastic side effects are experienced only in a very small number of cases.

The bottom line is that it's probably best to consult with your physician before taking St. John's Wort, especially if you are taking other drugs. With the herb's new found credibility, your doctor will take it seriously and be more than happy to advise you and monitor your usage of St. John's Wort.