TREATMENT:
NON-PRESCRIPTION MEDICATIONS & HERBAL REMEDIES
Herbal
remedies to treat depression include St. John's wort, SAMe,
ginkgo biloba, and caffeine. With the exception of St. Johns
Wort, there is insufficient clincial data to support the
use of these treatments.
St.
John's Wort (hypericum)
St.
John's Wort (wort is an old British word for 'plant') has
been studied the most extensively and been shown to have
the strongest effect up to now.
A
1996 report by Audie Murphy and colleagues published in
the British Medical Journal found that over 23 studies of
St. John's wort show that it is over twice as effective
for improving depression than simply taking a fake placebo
pill. For those whom it helped, the improvement was similar
to that seen by people taking standard antidepressant medications.
Click
here for a good website with detailed information on St.
Johns Wort.
St.
John's wort is used much more in European countries such
as Germany, but physicians in the United States are starting
to use it more and more. It works as a weak MAO-inhibitor
and as an SSRI. Like traditional antidepressant medications,
St. John's wort is a physiological active chemical and can
cause side effects. St. John's wort may cause upset stomach,
dry mouth, fatigue, dizziness, rashes, and itching, in addition
to possible food interactions as seen with other MAO-inhibitors.
Do not take St. John's wort if you are already taking other
antidepressants, and do not take other antidepressants if
you are already taking St. John's wort. Do not use the herb
if you are pregnant or nursing, or planning to become pregnant
while taking it. Consult your doctor with any questions.
Also, a few adverse drug interactions have been recently
identified between St. John's Wort (hypericum) and two drugs:
indinavir, a protease inhibitor used to treat HIV and cyclosporine,
a drug used to reduce the risk of organ transplant rejection.
Potentially dangerous changes in drug effects can occur
when medications such as cyclosporine (Neoral, Sandimmune),
digoxin (Lanoxin, Lanoxicaps) and warfarin (Coumadin) are
taken with hypericum extracts. Hypericum extracts can decrease
the blood levels of antiretroviral medications that are
used in the treatment of HIV infection, thus making these
drugs less effective. Recent data show that the plasma levels
of the protease inhibitor indinavir (Crixivan) were reduced
by more than 50% by hypericum (St. JohnÕs wort) products.
See
the following article for me details on the efficacy of
St. John's Wort: Linde, K. et al. "St. John's Wort for Depression:
A Meta-Analysis of Randomized Clinical Trials," British
Medical Journal (1996) 313:253.
Other
Remedies
SAMe (or S-adenosyl-L-methionine) is a chemical naturally
found in all the cells of our body, and has been found to
be as effective as antidepressant medications when used
in proper doses. It works much faster and has less side
effects. It is thought that it works by increasing the production
of neurotransmitters
such as serotonin and norepinephrine. While it has been
found to be safe for the use of pregnant, breastfeeding,
or women desiring to become pregnant, make sure to check
with your doctor when starting a course of medications (such
as SAMe) to treat depression.
Ginkgo
improves blood flow through the brain, and has helped many
people regain mental acuity and improve mood. However, it
also has side effects including diarrhea and irritability.
Some people believe that ginko stimulates the brain into
overdrive, and the long term effect of this is dangerous
(e.g., imagine running your car in 1st gear all the time:
it may have better acceleration at the start, but it will
burn out the clutch sooner). People taking aspirin or other
blood thinners should avoid taking ginkgo.
Caffeine
not only wakes you up, it can also improve mood, decrease
pain, and cause weight loss in some patients. Side effects
include agitation, insomnia and irritability, and like all
drugs, should be followed by a doctor if you are trying
to use it to deal with depressive symptoms.
