Herbal medicines to treat depression

Key Points:

  • The amount of research on herbal medicines for the treatment of depression is small when compared to the large amount of information on the use of prescription medication and psychotherapy for the same problem. Therefore, conclusions about herbal medicines are more uncertain.
  • The first medicines used to treat health conditions were derived from plants. There has been a strong interest over the years in using herbal medicines for a variety of problems including depression.
  • As with other medicines, herbal medicines must be taken in the right amount or dose to be effective. If you use one of these medicines be sure to check what dose would work for you.  Too high a dose may cause health problems.
  • Herbal medicines can interact with other commonly-used medicines and may have side effects, so it important to let your doctor and your pharmacist know if you are taking a herbal medicine along with other medicines (prescriptions or herbal ones).  It is especially important not to take them along with an antidepressant medication unless you have been advised to do so by a doctor.
  • While a number of herbal medicines have been studied as treatment for depression, only one, St. John’s wort (botanical name Hypericum perforatum L.) has been evaluated in enough well-designed studies to show that it can be helpful in the treatment of depression.
  • St. John’s wort (used at an effective dose) has been shown to be as effective as commonly-used antidepressant medicines.
  •  There has been no research on St. John’s wort as a treatment for the most severe forms of depression.
  • Persons taking St. John’s wort reported fewer side effects than those taking commonly used antidepressant medicines.
  • The strength or potency of herbal medicines, including St. John’s wort, may vary depending on the brand and the batch.  One reason for this may be the method used to extract the active ingredient from the plant.  To make sure that you receive a product with the recommended potency and without unhealthy contaminants, it is best to purchase from a supplier and manufacturer with a good reputation. Your pharmacy may be able to provide advice about the most reliable products.

Herbal medicines to treat depression

  • Your doctor may be able to provide information about good sources of St. John’s wort and the dose that is most likely to be effective.
  • Your doctor would also be a good source of information about possible interactions between St. John’s wort and other medicines you may be taking.
  • Other herbal medicines have been considered for treatment of depression but there has not been enough research to show if they are effective.  Future research will help us to understand which of these medicines may be effective.
  • Herbal medicines that include a single substance are more likely to have adequate purity and strength.  Medicines that combine a number of different plant substances in one preparation (such as a tea) are more likely to have problems with potency and may include ingredients that are unknown or not listed.
  • Dietary supplements have also been considered for treatment of depression.  For more information on this topic see Dietary supplements for treatment of depression.

Disclaimer: Information in this pamphlet is offered ‘as is’ and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

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Source: This summary provides scientifically accurate information.  It was prepared in a research review by researchers and young adults with the Mobilizing Minds Research Group.  The researchers are based at six universities: Manitoba, York, McMaster, Brock, Brandon, and Université Laval.  Our core community partner is mindyourmind.ca located in London, Ontario. Our young adult team members are located all across the country. Last revised:  7 January 2014.

Acknowledgement:  Preparation of this material was supported by funding from the Canadian Institutes of Health Research and the Mental Health Commission of Canada.  The views expressed here do not necessarily represent the views of these organizations.

References:

Chen, X.W., Serag, E.S, Sneed, K.B., Liang, J., Chew, H., Pan, S.Y., & Zhou, S.F. (2011). Clinical herbal interactions withconventional drugs: from molecules to maladies.  Current Medicinal Chemistry, 18(31), 4836-4850.

De Los Reyes, G., & Koda, R.  (2002). Determining hyperforin and hypericin content in eight brands of St. John’s wort. American Journal of Health-Systems Pharmacy, 59, 545-547.

Kasper, S., Gastpar, M., Moller, H.J., Muller, W.E., Volz, H.P., Dienel, A., & Kieser, M. (2010). Better tolerability of St. John’s wort extract WS 5570 compared to treatment with SSRIs: a reanalysis of data from controlled clinical trials in acute major depression. International Clinical Psychopharmacology, 25, 204–213.

Linde, K., Berner, M.M., & Kriston, L. St John’s wort for major depression. (2008). Cochrane Database of Systematic Reviews, 4. doi: 10.1002/14651858.CD000448.pub3.

Rahimi, R., Nikfar, S., & Abdollahi, M. (2009). Efficacy and tolerability of Hypericum perforatumin major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis. Progress in Neuropsychopharmacology and Biological Psychiatry, 33, 118–127.

Sarris, J.  (2013). St. John’s wort for the treatment of psychiatric disorders.  Psychiatric Clinics of North America, 36(1), 65-72. doi: 10.1016/j.psc.2013.01.004.

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Download: Fact Sheet Herbal medicines for Depression on our Fact Sheets web page.