St. John's Wort vs Antidepressants: You Won't Believe What This Doctor Says!

Raena Morgan: Dr. Scott, there's a section in your book where you talk about St. John's Wort, a natural, herbal supplement for depression, working as well as antidepressants, perhaps even better.  And yet we always hear that medicinal herbs are not as potent as drugs.  So how does that square with...

Timothy Scott: Well you have to remember that antidepressants do not cure depression.  Lets start with that basic understanding.

Morgan: You're firm on that right?

Scott: Yes, there's nothing in an antidepressant, all it's supposed to do is raise serotonin levels. Remember that there's no relationship between serotonin level and depression.  We know that from a host of studies.  George Ashcroft was the first to suggest that a lack of serotonin was the problem.  He later said, nope, we've done the studies now.  I was wrong.  So the basic idea behind antidepressants is false.  And of course, we can look at this in many different ways, prove that it's false in many different ways.  Put it simply, we know that young people have a lot more serotonin than do old people.  If the theory were true, all old people would be depressed.  They don't have much serotonin.  And no young people would be depressed.  That's the fact.  It doesn't match the theory.  Don't throw out the facts, you have to discard the theory.  So, ok, now.

Morgan: St. John's wort.

Scott: Let's talk about St. John's wort. St.John's wort has a real effect in terms of impacting depression.  Now, question.  How much of that is placebo.  I suspect it is largely placebo.  Again, these studies have to be double blind placebo studies that have an active placebo.  If you really want to know truth, and that's a difficult study to design, but it can be done.  And if we did one that had an active placebo compared to St.John's wort, I'm not sure how that's going to come out.  But I can tell you that when we compare st.John's wort with antidepressants, st.john's wort does as well.  Sometimes even better than antidepressants.  Now, the question is, what should you be on.  If they did, even, just as well, never better.  Let's suppose that was the end of their research.  I would still argue for St.John's wort!  For what reason?

Morgan: Yes.

Scott: Because you don't have, to our knowledge, some of the very serious effects that come about as a result of antidepressants.  We know with antidepressants you can have liver damage, we know that as a fact.  We know you can have sexual dysfunction.  We know it can affect weight.  We know it can affect diabetes, two to three times.  We know it can lead to tardive dyskinesia.  There are just a host of problems associated with antidepressants that to our knowledge, are not there for st.john's wort.  Doesn't mean we won't have some other concerns if people are taking large amounts over a long period of years.  But at this point I think it's probably the safer way to go. 

Morgan: Thank you.