Wednesday, January 28, 1998
St. John’s what?
HEALTH This is the spiffy headline that you, the omnipotent copy
editor will write and make fit nicely in this space about the story
below.
By Meghan Ward
Daily Bruin Contributor
No longer a "Prozac Nation", America is leaning towards herbal
remedies to cure every ailment from the common cold to
depression.
The growing popularity of St. John’s Wort, an anti-depressant
herb, now provides those suffering from mild to moderate depression
with a safe alternative to pharmaceutical anti-depressants.
St. John’s Wort (hypericum perforatum), a plant that grows in
the wild, is harvested each June for its active ingredient
hypericin. The plant derives its name from the its red spots, which
in Christian folklore represent the drops of blood shed by St. John
the Baptist when he was decapitated.
St. John’s Wort has been ingested for its healing properties for
over 2,000 years. According to Pamela Lee, a dietician at the UCLA
Medical Center, it was used by soldiers during the Crusades.
In Europe, the herb has been used to treat depression for the
past fifteen years and in Germany it is prescribed by doctors as an
anti-depressant twenty-five times as frequently as Prozac.
It was not until August of 1996, when the British Medical
Journal published a meta-analysis of St. John’s Wort, an analysis
of twenty-three individual studies, that the herb caught the
attention of the English-speaking world.
When Newsweek ran a story last May about the use of St. John’s
Wort as an attractive alternative to pharmaceutical
anti-depressants, the herb’s popularity among Americans soared,
making it a household word almost overnight. Because it is an
over-the-counter drug and does not require a doctor’s prescription,
it is easily accessible.
According to Dr. Hal Pruett, director of UCLA Student
Psychological Services, "one-fifth to one-quarter of Americans, at
some time or another, suffer from a significant depression."
Pruett explains that depression is a major concern for many
students and that "approximately 24 percent of the students we see
may be treated with some kind of medication, and anti-depressants
are the most common kind."
Pruett says that St. John’s Wort is not prescribed at Student
Psychological Services because it is not a prescriptive drug. and
because they don’t know much about it.
Dr. Joanne Dawson, director of Student Health, agrees that
"until a drug has undergone the scrutiny of the FDA, there is a
reluctance to say much about it. There are legitimate questions
about effectiveness," added Dawson. "Something can be legitimate
but not safe, safe but not effective."
Dr. Karlis Ullis, assistant clinical professor at the School of
Medicine emphasizes that St. John’s Wort has not yet been tested as
a treatment for serious or long-term depression.
"First, patients have to distinguish between major depression
and minor depression. Major depression is when you don’t want to
get up in the morning. You don’t experience pleasure in life.
There’s no motivation.
"A minor depression means you’re feeling out of sorts, you’ve
got the blahs and blues."
Dawson adds that if a person’s emotions are disturbing their
daily activities, they should talk to someone about the symptoms to
make sure they are not seriously depressed or suicidal.
But St. John’s Wort is not a panacea for depression. Its
greatest benefit is that is has been tested as equally effective to
pharmaceutical anti-depressants such as Prozac, Paxil, and Zoloft,
with greatly reduced side-effects.
While prescription anti-depressants can cause insomnia, sexual
dysfunction and a medicated feeling, St. John’s Wort’s primary
side-effect is hypersensitivity to the sun.
"It’s a strong photosynthesizer. Someone taking it can get very
sunburned." explains Lee. He recommends that fair-skinned persons
avoid exposure to the sun while being treated with St. John’s
Wort.
Other minor side-effects include slight fatigue and
restlessness.
Ullis advises those who experience fatigue to take the herb
before bedtime and those who experience sleeplessness to take it in
the morning.
St. John’s Wort elevates levels of serotonin and norepinephrine,
chemicals in brain cells that create elevated mood and
alertness.
"Some people are sensitive to the serotonin and they may feel
fatigued. Others may metabolize it more towards norepinephrine and
they will get a lift."
Ullis also warns against the use of alcohol while taking the
herb. "If you’re trying to alleviate depression, alcohol makes no
sense because it is a depressant." However, "one glass of wine
isn’t going to hurt you," Ullis conceded.
Though most doctors recommend avoiding tyramine foods (wine,
cheese, beer, yeast) while taking St. John’s Wort, there have been
no reported complaints from users who mix small amounts of these
substances with the herb.
Because it is a pscyhoactive drug, it will affect each person
differently.
According to Dr. Ray Sahalian, author of "St. John’s Wort:
Nature’s Feel-Good Herb", the recommended dosage is 300 mg of .3%
extract taken one to three times per day.
It is important that individuals buy a reputable brand with a
standardized dosage. If the dosage of each capsule is 300mg, but
the percentage of hypericin is not indicated, there is no way to
know how much of the herb is in each capsule.
Sahalian recommends that users begin by taking one capsule of
300mg of .3% per day for a week and increase to two or three if
necessary. "As with other medicines, the lowest effective dose
should always be used, and one should go off the medicine when it
is no longer needed" Sahalian explains.
Though some may feel the effects of the herb within a couple of
days, a minimum of two to eight weeks of treatment is necessary for
most to notice a significant improvement in their mood.
After the first month of treatment, patients are advised to seek
the professional guidance of a homeopathic doctor or a medical
doctor specializing in botanical medicine. They should have their
blood pressure taken and heart rate measured. For prolonged use,
the patient should take a blood test every three to four
months.
For more information about St. John’s Wort, see "Hypericum and
Depression" by Dr. Harold Bloomfield. Kelly Martin’s webpage at
www.geocities.com/SouthBeach/Lagoon/5942/dosage.html provides
extensive information and a range of testimonials by those who have
been treated successfully with St. John’s Wort.