Four Herbal Products that May Help Depression

In the last posting, I looked at the body of evidence for five herbal products which have been used to help treat depression. I found no medical proof that inositol, melatonin, fish oil, L-tryptophan, or gingko were effective for depression in a large scale study.

There are four herbal products where evidence shows some help for patients who were depressed. Don’t forget to ask your doctor or pharmacist before trying any of these products.

St. John’s wort- Likely Effective

What is it? An extract of a flowering plant. It’s still unclear how it functions in the body to help with depression.

Good: Best known herbal antidepressant. Majority of evidence suggests it improves mood and reduces insomnia for cases of mild to moderately severe depression.

Bad: Two large trials in psychiatric centers found it no better than a placebo. Many drug interactions with medications that treat depression, high cholesterol, psoriasis, rheumatoid arthritis, seizures, Crohn’s disease, HIV, and birth control (to name a few). Patients also may be more susceptible to cataracts if exposed to bright light while taking St. John’s wort.

S-Adenosyl methionine (SAMe)- Likely Effective

What is it? A chemical produced all over the body, but primarily in the liver.

Good: Generally well-tolerated, and has been used safely in large, multi-year studies.

Bad: Very expensive. The evidence also shows poor quality control in the available products. The product should not be combined with other antidepressants to avoid excess serotonin in the body, which could lead to a possible fatal overdose.    

Folic Acid- Likely Effective

What is it? A form of Vitamin B9 needed to produce healthy red blood cells.

Good: 500 micrograms might be effective when used with prescription antidepressants. Women may benefit more than men.

Bad: Not effective as a replacement for conventional treatment. It may hide a Vitamin B12 deficiency. There is no evidence folic acid prevents depression.

Saffron- Likely Effective

What is it? Extract is synthesized from the spice.

Good: Some evidence suggests taking 30 milligrams a day of saffron extract may improve symptoms after six weeks.  

Bad: More long-term safety and effectiveness study is needed.

If you decide to try one of these herbal products, be sure to talk with a pharmacist. There may be some serious interactions with your current medication. Also, be sure to tell your physician because herbal products may change the course of your treatment.

-Laura Challen, Pharm.D., BCPS, MBA, assistant professor of pharmacy practice

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