Nature’s Prozac St. John’s Wort Is Being Touted As An Herbal Cure For Depression. Does It Really Work?

Sherry Fenley spent the first 45 years of her life as a hard-working, energetic and upbeat person. She enjoyed her job as a dairy farm worker and never had any serious problems with her health.

But several years ago, she started having mysterious pains in her joints and found herself increasingly irritable and angry when faced with day-to-day problems which never used to bother her.

Then, after going through a divorce, she became “stressed to the point of losing” her health altogether, she said.

Months of medical tests found the autoimmune disease rheumatoid arthritis to be the cause of her aching joints, but her doctor was also concerned about her mental health. He diagnosed her with attention deficit hyperactivity Disorder and mild depression and recommended she take the anti-depressant Prozac. She refused, telling her doctor that pills weren’t for her.

After treating the rheumatoid arthritis for two years with an assortment of conventional therapies and simply suffering through her depression, Fenley saw a news report about St. John’s wort, an herbal remedy purported to ease the symptoms of depression. She decided to give it a try.

Just a few weeks later, the dark shroud of depression lifted from her life, as she suspected it might. But what surprised her was the extent to which her other symptoms were also alleviated. On a scale of one to 10, the Colbert resident confidently rates her physical and mental improvement as a solid “10.” She says the herb doesn’t make her feel drugged, simply “better.”

“This helped me be more accepting,” she said. “It helped my relationship with my kids — Mom’s a lot easier to get along with.”

Like thousands of people across the country who have never put much stock in the value of natural remedies, Fenley was willing to try St. John’s wort mainly because of the media attention it has been attracting lately. Also like many others, she kept using it because she found that it worked.

But for herbalists like Colville’s Charlene Larsen, the plant’s remarkable versatility is not surprising. She used a carefully controlled regimen of herbs, which included St. John’s wort, to recover from a severe brain injury she suffered after falling off a swing set in 1988.

Told by doctors she would never walk or talk again, Larsen says she is now able to live a happy and normal life with the help of a neck brace.

A trained nurse, she now admits it was scary relying exclusively on herbs for her recovery. However, she found the idea of brain surgery, the only alternative treatment for her injuries, to be intolerable.

Fortunately, her faith in herbs paid off.

Tracy Mendoza, a 35-year-old mother of three from Spokane, also had remarkable results with St. John’s wort.

Five years ago, Mendoza said she began a slow and painful slide into alcoholism that she attempted to reverse on several occasions by checking herself into treatment programs.

She said those programs unfortunately only compounded her problems by pumping her full of tranquilizers, which she also became addicted to.

Once out of treatment, Mendoza repeatedly returned to alcohol to counteract her tranquilizer withdrawal symptoms. After the failure of yet another recovery program last year, she had all but given up hope, though she would never have admitted that to her family or friends.

Then, shortly after her husband left and her two teenage daughters went to live with her sister in Ellensburg, an old friend of Mendoza’s suddenly appeared on her doorstep.

Seeing the condition she was in - by that point Mendoza says she was drinking a fifth of vodka per day - her friend, who had been using herbs for several years himself, persuaded the reluctant Mendoza to try a regimen of natural treatments, the centerpiece of which was St. John’s wort.

“I thought he was completely out of his mind,” said Mendoza.

But after only a week, Mendoza found her energy level improving dramatically and her craving for alcohol diminishing. By the time two months had passed, she was completely free of the urge to drink.

Better yet, she claims to have experienced virtually no symptoms of withdrawal.

Having been sober for four months now, Mendoza continues to take medication for high blood pressure, but that too is beginning to stabilize. She has taken a new job in an auto glass shop and says she has so much energy she hardly knows what to do with herself.

“I think I drive the people around me crazy because I just don’t stop,” she said.

Sharon Olson, a Spokane health care worker, astounded her doctor by using St. John’s wort to effectively rid herself of cluster headaches, extremely powerful migraines that had plagued her life for more than 30 years.

Though big news in America, the value of St. John’s wort and other herbal treatments has been recognized by the European medical community for years. In Germany, where doctors routinely dispense nearly 700 herbs for a wide variety of ailments, St. John’s wort was prescribed more than 25 times as often as Prozac in 1994 for mild and moderate depression.

Dr. William Corell, a family practitioner in Spokane, attributes the herb’s popularity in Germany to the fact that there is not as distinct a line drawn between natural remedies and conventional medicines in that country as there is in the United States. In addition, most American doctors are not trained in the use of herbs and are therefore reluctant to recommend them.

He hopes the success of St. John’s wort will help make U.S. doctors more open to the idea of natural medicine.

Although Corell says most depressed patients need counseling in addition to medication, he is excited about St. John’s wort because it is available without a prescription.

Some researchers, however, worry that the herb’s availability may lead the seriously depressed away from more intensive treatment.

The rapidly increasing consumption rate of St. John’s wort is certainly good news for health food merchants. Local operations like Top O’ The Line Health Food Store as well as larger chains such as General Nutrition Center are finding it difficult to keep the product on their shelves.

“We sell it out as fast as we get it,” said Faith Watkins, a sales clerk at GNC in NorthTown Mall. “Our warehouse is not allowing us to have as much as we want because it’s selling everywhere around the United States.”

The plant’s success has prompted a flurry of research seeking to determine if, why and how St. John’s wort works. Both the American-based Journal of Geriatric Psychiatry and Neurology and the British Medical Journal have devoted entire issues to publishing the results of experiments involving the plant. Overall, most studies seem to suggest that the herb is just as effective as conventional anti-depressants but has a much lower rate of complications.

But what is perhaps the most important research yet on the plant is currently being carried out by the federally-funded National Institute of Mental Health’s Office of Alternative Medicine, which plans to conduct a three-year nationwide study.

Dr. Benedetto Vitiello, the physician chosen to direct the operation, said he and his 10-member team are now choosing test sites and selecting the exact type and potency of St. John’s wort to be used. Soon, they will relocate to a coordinating center at Duke University to begin the $4 million project in earnest.

“If there’s a positive outcome, it’s possible more physicians will begin recommending it,” he said.

Positive results could also inspire the Food and Drug Administration to approve St. John’s wort as a drug, which would allow manufacturers to claim their product has the power to treat depression in their advertising, something now forbidden by the Dietary Supplement Health and Education Act of 1994. It would also make room for tighter government regulations relating to the production of St. John’s wort.

The federal study is important since most pharmaceutical companies are unwilling to conduct herbal research on their own since, unlike the case with synthetic drugs, it is impossible to patent a plant.

Clarke St. Dennis, an assistant professor of pharmacy practice at Washington State University and a researcher with Sacred Heart Medical Center’s Drug Studies Unit, said he is optimistic about St. John’s wort but warns that researchers are still unsure of the possible interactions it may have with other drugs. He recommends that people who already are taking a conventional anti-depressant not try St. John’s wort unless they are prepared to give up their other medications.

“I think it’s safe to say we don’t know how St. John’s wort will react to other drugs. It’s a real big question mark. It’s best to do one or the other,” he said.

While noting that all anti-depressants can have side effects and interactions that are complicated and difficult to detect, he said that, “as a rule, herbs have less side effects.” Indeed, many patients who cannot tolerate conventional anti-depressants have no problem with St. John’s wort.

Despite its low rate of complications, St. John’s wort does not work for everyone.

Spokane’s Mary Pikowski, a 42-year-old home health care worker, said the plant did nothing to help her chronic depression, while Hayden Lake’s Kae Walker, 49, says the herb gave her a rash after only a couple days of use.

In any case, people interested in trying St. John’s wort should realize that, like other anti-depressants, it is short-acting and needs to be taken every day for several weeks before it begins to take effect. Those currently taking any type of prescription medication should consult their doctor before trying St. John’s wort.

MEMO: This sidebar appeared with the story: MORE INFORMATION Psychiatrist Dr. Harold Bloomfield’s book, “Hypericum and Depression,” provides an in-depth look at the plant’s history and offers an overview of current research.