Has St. John’s wort been decanonized? The herb, which is used on a regular basis by more than 1.5 million Americans, showed “remarkably negative” results in treating major depression, according to a double-blind study published in the Journal of the American Medical Association.
The research, described as the most scientifically rigorous on the subject to date, involved 200 patients suffering from “major depression of at least moderate severity.” (The condition is defined as chronic sadness accompanied by multiple symptoms such as decreased energy, sleep disruption, appetite changes, feelings of worthlessness, and suicidal thoughts.) Volunteers were given 900 milligrams daily of St. John’s wort extract increased to I 200mg if no progress was seen or a placebo. After two months, slightly more patients taking St. John’s wort showed improvement (27 percent vs. I 9 percent), but the study’s d rector dismissed the disparity as coincidental and statistically insignificant.
“The most dangerous treatment is the treatment that doesn’t work” said Richard C. Shelton) a professor of psychiatry at Vanderbilt University in Nashville.” I would recommend choosing an active treatment rather than St. Johns wort. According to separate research, prescription antidepressants relieve at east some symptoms of major depression in 60 percent to 80 percent of cases. Shelton also questioned the validity of more than 20 previous studies that indicated St. John’s wort might be an effective alternative to antidepressants. Each study had at least one major flaw, he said.
Proponents of herbal therapy were quick to find flaws in the new study, primarily noting that St. John’s wort is recommended only for mild depression. Consumers wouldn’t use a throat lozenge for strep throat, but that same lozenge might be just right for the first stage of a cold, said John Cardellina, Vice president of botanical science at the Council for Responsible Nutrition, a trade group. “The substantial body of evidence for the value of St. Johns wort for mild to moderate depression should not be arbitrarily dismissed by this study.”
The nonprofit American Botanical Council issued a statement questioning the study’s low placebo response, which typical reaches 30 percent to 50 percent. The lack of an active [pharmaceutical] treatment arm” may have lowered expectations in the investigators, the raters and the patients, suggested the council. “In the minds of some, this was a clinical trial comparing two inactive treatments.”
Shelton called his work “very well done” but still “only one study.” He is waiting to see if his results are confirmed by a current National Institutes of Health investigation comparing St. Johns wort, a placebo and the antidepressant Zoloft.