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DEPRESSION: SHOULD I GO HERBAL OR THE MEDICATION ROUTE?

I have some patients with depression who have asked if taking St. John’s Wort is adequate in the treatment of Depression.
My answer? It depends.

This meta-analysis of 27 clinical trials, totaling more than 3,800 patients, compared St. John's Wort and selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants.

The conclusion that St. John's Wort has "comparable efficacy and safety" compared to SSRIs for patients with mild to moderate depression. However, it wasn't seen to be effective for patients with severe major depression. 

In my experience, if you've had depression for less than six months, I usually suggest trying St. John’s Wort as a chemical remedy.

One advantage of using St. John’s Wort is that it has fewer side effects than antidepressants. Antidepressants can have side effects such as weight gain, sexual dysfunction, fatigue and insomnia for some. Usually I see these side effects in the higher doses of antidepressants. There are some antidepressants that are worse than others as far as side effects are concerned.

For recurrent types of depression, especially if it's been longer than six months, I suggest trying antidpressants to increase serotonin and other neurotransmitters.

Of course, I also believe in trying other forms of help. I am a strong believer of Cognitive Behavioral Therapy (CBT) which seems to have the most promising research out as far as effectiveness. However, in the more severe types of depression the best combination appears to be a therapy like CBT combined with an antidepressant. That appears to be the quickest route to the remission of moderate to severe Depression.  

If you are not sure what type of treatment is best for you I would suggest you confer with a mental health specialist who prescribes, either a Psychiatric Mental Health Practitioner (sometimes called an Advanced Practice Nurse) or a general practitioners. In some states Clinical Nurse Specialists (CNS) in mental health can also do the evaluations and prescribe medication.

In short, if you've had symptoms of depression, get help. There are so many ways to help out your brain!

Author
Satu H. Woodland, PMHCNS-BC, APRN Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.

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