I fear I will get flamed for posting this, but remember: I'm just the messenger!
http://www.nationalpost.com/home/story.html?f=/stories/20020410/600106.html
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St. John's wort poor remedy for depression, study finds
April 10, 2002 Mary Vallis National Post, with news services
Use of popular herb is 'like playing Russian roulette with your health,' doctor says
People taking St. John's wort to treat serious depression might as well be popping sugar pills, new research suggests.
The largest, most rigorous clinical trial to test the herbal supplement's power as an antidepressant found that, in spite of its popularity, it is not effective for people with moderate or severe depression.
The researchers also warn consumers that taking herbal remedies, such as St. John's wort, is like playing Russian roulette with their health because they can have adverse effects.
"Not only is there the question of do they work, but there's the question now that we're becoming much better more informed about: Can they cause harm?" said Dr. Jonathan Davidson, the study's lead author and director of Duke University's Anxiety and Traumatic Stress program in Durham, N.C.
Past studies have found the herb may weaken or negate the effects of crucial medications, including birth control pills, medications to prevent organ rejection after transplant surgery and drugs used to treat heart disease and AIDS.
A small study released on Monday also suggested the herb, a weed with a long history of medicinal use, may interfere with chemotherapy treatments for cancer.
Another author of the new study, Dr. Robert Califf, director of the Duke Clinical Research Institute, said: "As long as these types of products remain available to the public without the protection of adequate, controlled and unbiased studies, taking them is like playing Russian roulette with your health."
The bottom line, said Dr. Davidson, is if people suspect they are depressed, they should contact their doctors before selecting herbal remedies from store shelves -- especially if they are already taking medications for other ailments.
For the study, which appears today in the Journal of the American Medical Association, Dr. Davidson and his colleagues tested St. John's wort against a placebo and the popular antidepressant sertraline, which is sold under the trade name Zoloft.
A total of 340 patients with major depression were randomly assigned to get an extract of St. John's wort, sertraline or sugar pills for eight weeks. Patients in the blind study who responded to their treatment favourably were allowed to continue for another 18 weeks.
The researchers found St. John's wort was not effective when they used diagnostic scales to evaluate the patients' levels of depression. The same was true of sertraline -- although the researchers find it effectively relieved stress.
The findings contradict previous studies of St. John's wort that suggested the herbal supplement alleviated many of the symptoms of depression. The Duke researchers say the authors of those studies did not clearly describe the forms of depression included in their research.
Critics of the Duke study, however, say its results are confusing. The results cannot be conclusive because the patients on sertraline did not show substantial improvement, said Dr. John Cardellina of the Council for Responsible Nutrition, a trade group representing herbal supplement manufacturers.
Dr. Cardellina said St. John's wort was never intended for use by severely depressed patients. Dozens of studies have shown it to be effective in cases of mild, temporary bouts of depression, he added.
That may be true, but the Duke study cannot address those claims because it did not examine such cases, Dr. Davidson said.
The popularity of herbal remedies has boomed in North America in recent years, proof that the number of people who eschew conventional medical treatments and believe natural products are healthier is on the rise. Sales of St. John's wort in the United States were estimated at US$210-million in 1998.
Sales in Canada seem to be ebbing. According to the Nonprescription Drug Manufacturers Association of Canada, about 7.4% -- or just more than two million Canadians -- used the herb in 1999, with the greatest number in British Columbia. As of November, 2000, however, sales had plunged by 20%, followed by another 12% drop in 2001. ===========================================================================
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