Clinical Studies On Depression. herbs for depression ?

Q.remember, to the extent that herbs (like St. John's Wort) do function as antidepressants, they can also have the side effects of prescription antidepressants. Just because they're "natural" doesn't mean they won't do anything unpleasant

A.There have been several dozen studies looking at the effectiveness of St. John's wort. The British Medical Journal recently conducted a study of 23 randomized trials involving over 1,700 patients. The patients had mild to moderate depression. St. John's wort was just as effective as standard antidepressants. However, none of the studies exceeded 12 weeks in duration making them less than ideal. Fifty percent of patients taking St. John's wort improved with respect to their depression as opposed to only 23 percent of patients that were taking placebo. In several studies, St. John's wort was more effective than standard antidepressants for mild to moderate depression. To my knowledge, there are no studies proving the effectiveness of St. John's wort in severe depression or manic-depressive illness. I would not recommend starting with St. John's wort in patients with severe depression until St. John's wort has been proven to be as effective as standard antidepressants. an herb that has shown promise in treating mild to moderate depression, does not seem to work against a more severe form of the disease, according to a study being published in the Journal of the American Medical Association. The herb worked no better than a placebo in a study of 200 adults diagnosed with major depression. In an earlier analysis of some 23 studies on St. John's wort on patients with less severe forms of the disease, the herb was found to be significantly superior to a placebo and just as effective as standard antidepressant drugs. But you'd really have to read the whole article to get these snippets. The combined response/remission rate for SJW was 40.8%. The similar combination for placebo was 23.9%. Only 4.9% remitted on placebo, which is quite astounding, as typical placebo remission rates stand at 25 or 30% in other clinical trials. How can we account for this finding? Simple. Consider the subject pool. Only subjects with extended periods of current depression (non-remitters) were included in the study; the authors state that the mean (SD) duration of current major depressive disorder was 2.3 (6.3) years in the treated group and 2.7 (5.6) years in the placebo group. In other words, the subjects seem to have been specifically selected to be non-responders. As there was no active comparator (e.g. a proven antidepressant) in this trial, there is no way to know if *any* treatment could have been successful here, let alone SJW. But, SJW was significantly more effective than placebo, even though the stated conclusion is at odds with the evidence.

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