St John's Wort 'Better Than Drugs For Depression'
By Jeremy Laurance - Health Editor - The Independent - UK -
10 February 2005
A specially prepared extract of the herb St John's wort is at least
as effective in treating depression as the powerful antidepressant
drug Seroxat [Paxil] and has fewer side-effects, a study has indicated.
St John's wort has long been known as an effective herbal treatment
for mild depression but the latest study is the first to suggest
that it may have equal effectiveness with one of the biggest-selling
pharmaceutical treatments for moderate to severe depression.
Researchers who asked 301 people with depression to take part in
the trial found that half of those given St John's wort for six
weeks reported an improvement in their symptoms, compared with only
one third given Seroxat.
Neither group knew which drug they were taking, but those given
Seroxat also reported more side-effects.
Seroxat has been at the centre of allegations that in some patients
it causes agitation at the start of treatment and withdrawal effects
in those trying to come off it. An investigation by the Medicines
and Healthcare Regulatory Authority concluded last year that it
should be avoided in mild depression, because of the side-effects.
The authority ordered a ban on its use in patients under 18.
The study is published in the online version of the British Medical
Journal. The researchers from Germany say: "Our results support
the use of [St John's wort extract] as an alternative to standard
antidepressants in moderate to severe depression, especially as
it is well tolerated." They add that the drug should be assessed
for long-term treatment, because many patients suffer chronic depression
and the "favourable ratio between efficacy and tolerability"
of St John's wort makes it an "interesting option" in
these patients.
In 2004, about 19 million prescriptions for antidepressants were
issued to about 3.5 million patients at a total cost of £400m
in the UK.
In recommendations issued in December, the National Institute for
Clinical Excellence (Nice) said that given the well-known side-effects
of such drugs, including anxiety, insomnia, headaches and stomach
complaints, alternative treatments should be considered for people
with mild depression.
Nice recommended that counselling including cognitive behavioural
therapy should be considered. But the Royal College of GPs said
the shortage of counsellors and psychotherapists meant this was
impractical. "GPs often feel they have little choice but to
prescribe antidepressants," a spokesman said.
In Germany, where St John's wort is a prescription drug, it outsells
Prozac by four to one.
One drawback is that St John's wort interacts with several prescription
medicines to reduce their effectiveness.
©2005 Independent News & Media (UK) Ltd.
http://news.independent.co.uk/
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