Monday, September 03, 2007

St. John's Wort Vs. Celexa

A once-daily dose of St. John's wort extract finished in a dead heat against the popular pharmaceutical anti-depressant Celexa for cases of moderate depression. Side effects were fewer in those taking St. John's wort compared to Celexa. (Lexapro is the newer version of Celexa.)

That was the result of a study conducted in Germany last year and reported in the journal Pharmacopsychiatry .1, 2

Study Specs
  • Clinical trial: Double-blind, randomized, placebo-controlled, multicenter
  • Participants: 388 outpatients, 6-week treatment
  • Interventions: St John's wort 900 mg/day, or Celexa (citalopram) 20 mg/day, or Placebo
Based on changes in mood and number of people responding, "The hypericum [St. John's wort] group was not statistically different from the citalopram [Celexa] group, and significantly superior to the placebo group."

"Significantly more adverse events with "certain", "probable" or "possible" relation to study medication were documented in the citalopram group."

"These results revealed that hypericum extract STW3-VI is a good alternative to chemically defined antidepressants in the treatment of outpatients with moderate depression."
There's a wealth of untapped therapeutic aid to be found in botanicals. It's unfortunate there isn't a good pool of research to assure its safety and efficacy, not in the US at least. I don't expect that will change soon given the disparity in industry profits between herbals and synthetics:

Retail price for 30 day supply:No wonder Europe embraces herbal medicine. (The National Institute of Mental Health states that, "Today in Germany, Hypericum [St. John's wort] is used in the treatment of depression more than any other antidepressant.") Their governments are footing their healthcare bills.

Related Post: Depression Ups the Risk for Heart Attack

1 Comparative Efficacy and Safety of a Once-Daily Dosage of Hypericum Extract STW3-VI and Citalopram in Patients with Moderate Depression: A Double-Blind, Randomised, Multicentre, Placebo-Controlled Study
2 It's a good idea to check with your doctor before self-medicating depression. There's a risk in undertreating more potent, clinical depression. And it's come to light that children and adolescents may experience sudden, undesirable changes in mood while taking an antidepressant. In regards to St. John's wort specifically, this herb affects a particular enzymatic pathway that the body uses to metabolize drugs. As such, it may interfere with the action of other drugs you may be taking. Just get the nod from your doc.


Anonymous said...

Where do I get STW3-VI ??

Anonymous said...

Have any studies been conducted to investigate the effectiveness of small amounts of St. John's Wort used in conjunction with a standard dose of Celexa, or vice/versa? I know that St. John's Wort and Celexa, when taken togher, can induce a Serotonin Syndrome, but wouldn't there be a way to get the best of the both the synthetic pharmaceutical and the herbal remedy simulataneously?

Bix said...

I don't know the answer to your question. But it's an interesting question, because something I do know about St. John's wort is that it revs up enzymes in the cytochrome P450 pathway. That pathway metabolizes, or breaks down, drugs we take. So, the more St. John's wort you take, the less effective other pharmaceutical drugs may be. (It also inhibits some enzymes in that pathway, so it's not easy to predict what its interaction will be with other drugs.)

Here's one study that found St. John's wort reduced availability (so, effectiveness) of Xanax:

Anonymous said...

Because of this study I talked to my doctor and switched from 20mg/day Citralopram to 900 mg/day St. John's Wort. At doctor's advise I stopped taking Citralopram for 6 days before I started St. John's Wort. I have been using St. John's Wort for only 4 weeks, but started noticing the difference in the first week already. I am very happy with the result. I definitely have no signs of depression now, and I feel significantly better than with Citralopram. For me St. John's Wort is superior to Citralopram both in the effect on my depression as well as the side effects.

I have been having medium depression for abput 10 years, without medication I don't think I could go to work regularly. I have been taking Citralopram for about 6 years, before that I took other chemical antidepressants. Sideeffcts of Citralopram for me were emotional flatness, diminished sex drive, no interest in a relationship, and a dislike for any kind of music (I hadn't listened to any music for about 10 years).

I would say St. John's Wort is more effective than Citralopram for me (I did sometimes slip into mild depressions using Citralopram and I often felt just ok) with no sideeffects. For those reasons I would rate my experience about 20% better than with Citralopram. St. John's Wort doesn't suddenly cure depression, but the difference to Citralopram is quite noticeable: I feel less medicated, emotionally more natural, my sex life has become more active, and I can finally listen to music again.

Anonymous said...

As a German I can confirm that St. John's Wort (and other herbal medicines) are very popular in Germany. The reason for that is Germany has a long tradition of herbal remedies since the middle ages, and people generally are sceptical of chemical drugs. Homeopathy comes from Germany and is also very popular. I don't beloeve price is a deciding factor here, because if you look for generic Citralopram instead of brand-name Celexa you can get a 30 day supply for as low as $3.50 (

Bix said...

That was a great testimonial. Thank you for taking the time to write and post it.