I have been taking Zoloft for about a year for PMS symptoms (not depression). Because I have noticed hair loss, I have decided to stop taking the drug and I have tapered slowly at the advice of my doctor I have heard that St. John’s wort is effective in many ways as a substitute for antidepressants. Will you comment on its effectiveness?
What about side effects? I can find very little information about this herb. Also, what about any drug interactions? Right now, I’m only taking Lamisil for a foot fungus. I also regularly take fiber, calcium citrate, and a multivitamin.
St. John’s wort has received a great deal of publicity in the past and is being frequently prescribed by herbalists for depression. It is licensed in Germany for the treatment of anxiety, depression, and insomnia, but I could find no indication that it might be helpful in relieving your PMS. If Zoloft has been effective for you, then the active ingredient of St. John’s wort – hypericin, which is thought to inhibit certain brain neurotransmitters in a similar way — may be helpful.
The concentration of hypericin may vary from one part of the plant to another and from one growing season to another. Therefore, it is difficult to know how much of the active ingredient is present in the extracts sold. Since St. John’s wort is considered a dietary supplement, not a drug, by the Food and Drug Administration, no standardization is required. Research on hypericin is now being conducted.
Reported studies on St. John’s wort have been small and often short in duration — from two to 12 weeks. Many of these studies found the herb to be superior to a placebo, and about as effective as regular antidepressants, in treating mild to moderate depression. However, the diagnosis of depression was not standardized in many of the studies, and some of them compared the herb to doses of standard antidepressants which were smaller than those customarily used.
Side effects have generally been reported as mild and few in number. There have been reports of skin outbreaks on exposure to sunlight; similar reactions have been seen in cattle that have grazed on St. John’s wort. So little is known about the pharmacology of the drug that I can’t comment on the possibility of an interaction with Lamisil. St. John’s wort should not be taken with other antidepressants such as Zoloft or Prozac.
Because of the small amount of research on the drug and the lack of standardization, it is difficult for me to make any recommendation. If you take the herb and your PMS is improved, that could be either a real pharmacological effect or a placebo effect. Many doctors would say, “Who cares if it is a placebo effect if it works for her?” and I wouldn’t disagree, if I were totally sure of the herb’s safety. I would certainly advise any woman taking St. John’s wort to avoid becoming pregnant while on the herb. Thalidomide was an approved drug in Germany and thousands of pregnant women took it before its terrible effect on fetuses was recognized.