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St. John’s Wort as Effective as Pharmaceuticals for Mild Depression

Several years ago, the herbal antidepressant St. John’s Wort (SJW), best known for its excellent combination of effectiveness and absence of side effects, was dealt a serious and unfair blow by the US pharmaceutical industry. But there’s a hopeful end to this tip, so read on.

In an example of how the industry’s greed will stop at nothing to dismantle competition, Pfizer, maker of the antidepressant Paxil, actually went through a series of complicated steps to destroy SJW, which was emerging as an effective alternative to prescription antidepressants.

First, Pfizer acquired a small herbal supplement company. Second, with the stated goal of “public safety,” Pfizer sponsored a study using SJW for depression, minimizing the fact that the patients they selected had been referred from other doctors as those with very deep depression for whom antidepressants hadn’t worked. Naturally, SJW didn’t fare well and Pfizer’s wish came true. A study bashing SJW was published in the Journal of the American Medical Association (JAMA). Follow-up articles appeared all over the popular press stating SJW just didn’t work.

About a year later, a largely unread article in the British Medical Journal tore apart the JAMA article, commenting acidly that the researchers had deliberately ignored more than 100 previous studies showing SJW’s effectiveness, and that the project was tainted since the researchers were on Pfizer’s payroll.

But the damage had been done. Sale of SJW plummeted and, for years, most conventional physicians in the US continued to believe the herb didn’t do anything for depression. Until now.

A European meta-analysis of SJW reviewing 29 previous studies tracking 5,500 patients has been published with some very interesting findings. Understand that a meta-analysis examines data of already existing research to make sure the numbers were interpreted correctly. Meta-analysts look for such study flaws as incorrect patient selection, inadequate dosages, and incorrect interpretation of results. The Pfizer study would be regarded as deeply flawed because of incorrect patient selection and financial conflict-of-interest.

Here are the results of the meta-analysis:
• SJW works better than a placebo (dummy pill) for mild to moderate depression.

• SJW works for mild to moderate depression about as well as prescription SSRI antidepressants (such as Prozac, Paxil, Zoloft, Celexa, and Lexapro.) It’s less effective for more severe depression, where higher doses of prescription medications are needed.

• Prescription SSRIs are often discontinued because of side effects, most commonly weight gain, diminished sexual interest, and emotional flatness.

• SJW has virtually no side effects.

• SJW is a more effective antidepressant in German-speaking countries, apparently because patients and physicians believe in its effectiveness. Parenthetically, this phenomenon of “mutual belief” (or lack thereof) has been shown to transcend virtually all therapies. Patients who “know” surgery or chiropractic or acupuncture will help them have better results than skeptics and doubters.

Keep in mind that the European investigators received no financial incentives to perform this study. In response to this meta-analysis, a reporter contacted Dr. Richard C. Shelton of Vanderbilt University, who had been extremely well paid by Pfizer several years earlier for his article demolishing SJW. Not surprisingly, Dr. Shelton dared not bite the hand that (over)fed him. He stated categorically that these European findings “should be considered with some skepticism” and that further studies were needed.

For further reading on the subject of the corrupt relationship between some doctors and drug companies. Click this link for a New York Review of Books article “Drug Companies & Doctors: A Story of Corruption,” on the incredibly tainted collusion between the pharmaceutical industry and academic medicine, especially academic psychiatrists. It’s written by Marcia Angell, MD, former Editor in Chief of The New England Journal of Medicine, and its thesis is likely to shock you.

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