Question: Are herbal compounds (such as St. John?s Wort) effective treatments?
Answer: Treatments such as St. John's Wort have been actually extensively studied in adults with major depression. And it turns out that St. John's Wort probably works just as well as most antidepressants in people with mild to moderate depression. But once you get to moderate or severe depression, it's much less effective, whereas conventional medications do show efficacy in people with moderate and severe depression.
In addition, St. John's Wort isn't always benign. People think of natural treatments as totally safe, but they're not always that way. For instance, St. John's Wort has a lot of drug interactions. If you're taking a drug that's metabolized by a certain enzyme in your liver for instance, and you add St. John's Wort the levels of the first drug can drop dramatically. And this was shown with people that had heart and kidney transplants that were getting cyclosporine, which is an antirejection drug. And it turns out that several patients in this one clinic were using St. John's Wort and they suddenly had all these acute rejection episodes. And it turns out it was the St. John's Wort that caused a lowering of the cyclosporine levels to nearly zero.
So if you're going to use St. John's Wort, make sure you do it in consultation with your doctor and make sure they're aware of the serious drug interactions that can occur.
But some people prefer the natural approach to the treatment even though it may not be superior in efficacy, sometimes there are less side effects with some of these drugs.
In countries like Germany, treatments like St. John's Wort actually are used much more frequently than SSRI antidepressants like Prozac or Zoloft.