St. John's wort Research:

Anecdotal Evidences?

There have been innumerable reports on the medicinal efficacy and internal and external use of St. John's wort in Europe and among Native Americans throughout history. Many of the old applications have now proven scientifically valid. Approval by German Commission E as drug highlights it, and the enormous popularity St. John's wort is enjoying around the world testifies it.

Scientific and Clinical Studies

It was once believed that St. John's wort's efficacy was through one of its active compounds hypericin, which was shown to be inhibitory of monoamine oxidase (MAO) activities by Japanses scientists in 1984. This appeared to be a credible reasoning in light of the mechanisms of the synthetic anti-depressant drug Nardil and the efficacy of other MAO inhibitor chemicals as anti-depressant drugs. This hypothesis was countered in late 1990s that neither MAO inhibition nor hypericin plays a main role of St. John's wort as an anti-depressant. Interestingly, however, both St. John's wort and its standardized extract made to 0.3% hypericin work just fine in treating depression. Many scientists now believe St. John's wort's flavonoids and other compounds, rather than those responsible for MAO inhibition, somehow produce its anti-depressant effect. St. John's wort researches also found its actions on mild inhibition of the reuptake of serotonin by neurons, (which is currently being downplayed as the effect is weak, and requires high dose of St. John's wort,) increase of dopamine levels in the brain, which is yet another important neurotransmitter associated with moods, (there are other class of anti-depressant drugs that enhance mood by increasing the brain domapine level,) and increase of GABA (gamma-amino-butyric acid), (another important nuerotransmitter. Low GABA level has been assocaited with manic depression,) in the brain, even at a very dilute, low dose of St. John's wort. The most recent theory is that St. John's wort might produce anti-depressant effect through immune-enhancing mechanisms, rather than through modulating brain neurotransmitter levels. Or it could be the combinatorial or synergy effects through which St. John's wort work as an effective anti-depressant.

Although the biological action of St. John's wort is still not conclusive, one thing is clear: St. John's wort works, with no question. Since 1980s, numerous clinical trials on St. John's wort, mostly in Europe and very few of the reports published in English, have been conducted on thousands of patients. These clinical trials have shown that St. John's wort works equally well to synthetic drugs, and with much less side effects, even less than placebo! Recently, St. John's wort is gaining attention in the US, and US National Insitute of Health has begun to support researches on St. John's wort through its three branch offices, Office of Alternative Medicine, National Institute of Mental Health, and Office of Dietary Supplements.

Outlook

Recent studies in the US confirms the earlier observations from European investigations on St. John's wort.

Anxiety is a common form of depression. Knowledge aleady gained about St. John's wort suggests that it might be particularly useful in treating one of the anxiety disorders, called "generalized anxiety disorder" (GAD). GAD develops gradually, and primary manifestation of GAD is excessive worries over a prolonged time period (several months). GAD often disappears as people get older. Another popular form of anxiety is "seasonal affected disorder" (SAD). People with SAD experience lethargy, long sleep, and craving for food, especially for carbohydrates, which are overall symptoms of "winder blues", a form of depression. SAD tend to run through family, and afflicts over 11 million people in the US periodically. St. John's wort once was a pesky weed particularly in California, Oregon and Washington states, as they grew so abundantly. Cattle grazing on the fields inadvertantly ate tons of St. John's wort and developed photosensitivities, such as blisters around eyes and mouth. A movement was initiated to eradicate St. John's wort and even a monument was erected by US Department of Agriculture to commemorate the annihilation of the pesky weed. As the demand for St. John's wort picked up in 1980s, and St. John's wort was short of supply, the humble weed became a cash crop and once again started to cover the fields around the world, including the US, Europe, and China.