Depression and St. John’s wort

Help depression naturally

St. John’s wort (Hypericum perforatum) is perhaps the best known of the herbal remedies for depression. While not native to the U.S., this weedy perennial is found in nearly every state and can grow one to three feet tall with small yellow flowers.¹

There are several studies supporting its effectiveness in treating depression. It is important to understand this tool for depression as well as the importance of addressing depression in patients.

Depression in our population

Between 2009 and 2012, nearly 8 percent of Americans over the age of 12 experienced moderate or severe depressive symptoms during any given two weeks. Over 40 percent of people suffering from depression reported difficulty with work, home, and social situations.²

Depression was more common among women and adults between the ages of 40 and 60. It was also two and a half times more likely to occur for those Americans living below the poverty level, as compared to those either at or above poverty level.²

In addition to well-known symptoms such as lack of appetite, insomnia, and sluggishness, pain may also be associated with depression. In particular, chronic back pain is frequently coupled with depression, making it difficult for patients to sleep, concentrate, or do simple daily tasks.³

Identify depression

Given that back pain is the most common complaint bringing patients into a DC’s office, there is a good chance that these patients could be suffering from depression related to their chronic back pain. DCs should ask patients about their emotional state and prescription medications either during intake or exam.³ This can help determine the severity of the depression, if they are attempting to treat depression with medication, as well as track these over visits.

St. John’s wort compared

A study published in the journal International Clinical Psychopharmacology compared the use of St. John’s wort to the most commonly prescribed antidepressant, Prozac (fluoxetine). One group of patients received 250 mg twice daily of St. John’s wort, and the other group received 20 mg per day of fluoxetine. At the end of six weeks, patients taking St. John’s wort scored better on standardized depression tests than those taking fluoxetine. Furthermore, St. John’s wort had a lower incidence of adverse events (8 percent), compared to fluoxetine (23 percent).⁴

A second study compared the use of the herb to another popular antidepressant, Zoloft (sertraline). In this study, 47 percent of patients receiving St. John’s wort showed at least a 50-percent improvement in symptoms (considered to be clinically significant), as compared to 40 percent of those taking Zoloft.⁵

DCs can help

While patients may not think to ask their chiropractor to treat mental health issues, DCs can still provide support in this area. By elevating pain through chiropractic adjustments and recommending herbal medications such as St. John’s wort, DCs will impact depression in their patients.

References

¹ USDA NRCS Cape May Pland Materials Center. “Common ST. Johns wort.” http://plants.usda.gov/factsheet/pdf/fs_hype.pdf. Published July 2012. Accessed August 2012.

² Pratt LA, Brody DJ. Depression in the U.S. Household Population, 2009-2012. National Center for Health Statistics Data Brief. December 2014, No. 172.

³ Deardorff WW. “Depression and chronic back pain.” Spine-health.com. http://www.spine-health.com/conditions/depression/depression-and-chronic-back-pain. Published October 2004. Accessed August 2015.

⁴ Schrader E. Equivalence of St. John’s wort extract (Ze 117) and fluoxetine: A randomized controlled study in mild-moderate depression. Int Clin Psychopharmacol 2000;15(2):61-8.

⁵ Brenner R, et al. Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: A double-blind, randomized pilot study. Clin Ther 2000 Apr;22(4):411-9.