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    Daniel K. Hall-Flavin, M.D.

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Question

Natural remedies for depression: Are they effective?

I've heard natural remedies for depression, such as St. John's wort, can work as well as antidepressants. Is that true?

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from Daniel K. Hall-Flavin, M.D.

Natural remedies for depression aren't a replacement for medical diagnosis and treatment. But, for some people certain herbs and supplements do seem to work well. More studies are needed to determine which natural remedies for depression are most likely to help and what side effects they might cause. Here are four natural remedies that show promise:

  • St. John's wort. This is an herb that's been used for centuries to treat a variety of ills, including depression. It's not approved by the Food and Drug Administration (FDA) to treat depression in the United States, but it's a popular depression treatment in Europe. It may be helpful if you have mild or moderate depression. However, it should be used with caution — St. John's wort can interfere with a number of medications, including antidepressants, HIV/AIDS medications, drugs to prevent organ rejection after a transplant, birth control pills, blood-thinning medications and chemotherapy drugs.
  • SAMe. This dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name SAMe (pronounced sam-EE) is short for S-adenosylmethionine (uh-den-o-sul-muh-THIE-o-neen). Like St. John's wort, SAMe isn't approved by the FDA to treat depression in the United States, but it's used in Europe as a prescription drug to treat depression. SAMe may be helpful, but more research is needed. In higher doses, SAMe can cause nausea and constipation.
  • Omega-3 fatty acids. These fats are found in cold-water fish and in some nuts and certain plants. Omega-3 supplements are being studied as a possible treatment for depression and for depressive symptoms in people with bipolar disorder. While considered generally safe, the supplement can have a fishy taste, and in high doses, it may interact with other medications. Although eating foods with omega-3 fatty acids appears to have heart-healthy benefits, more research is needed to determine if it has an effect on preventing or improving depression.
  • Saffron. Saffron extract might improve symptoms of depression, but more study is needed. High doses can cause significant side effects.

In the past, the quality of many dietary supplements on the United States market was often questionable. With increased oversight by the FDA, this concern is gradually lessening. But it's still best do some research before starting any dietary supplement. Make sure you're buying your supplements from a reputable company, and find out exactly what they contain.

Also keep in mind that some herbal and dietary supplements can cause potentially dangerous interactions with other medications. To be safe, talk to your doctor before taking a supplement for your depression.

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References
  1. Nahas R, et al. Complementary and alternative medicine for the treatment of major depressive disorder. Canadian Family Physician. 2010;57:659.
  2. Carpenter DJ. St. John's wort and s-adenosyl methionine as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.
  3. Evans R, et al. Which nutritional therapies are safe and effective for depression? The Journal of Family Practice. 2011;60:99.
  4. SAMe. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=786&ds=adverse&lang=0. Accessed June 25, 2012.
  5. Depression and complementary health practices: What the science says. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/providers/digest/depression-science.htm. Accessed May 10, 2012.
  6. Cohen PA. Assessing supplement safety — The FDA's controversial proposal. The New England Journal of Medicine. 2012;366:389.
  7. St. John's wort. National Center for Complementary and Alternative Medicine. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=329&ds=&name=ST.+JOHN'S+WORT&lang=0&searchid=35485618. Accessed June 25, 2012.
  8. Saffron. National Center for Complementary and Alternative Medicine. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=844&ds=&lang=0. Accessed June 25, 2012.
  9. Albanese E, et al. No association between fish intake and depression in over 15,000 older adults from seven low and middle income countries &mdash The 10/66 Study. PLoS One. 2012;7:e38879.
  10. Sarris J, et al. Omega-3 for bipolar disorder: Meta-analysis of use in mania and bipolar depression. Journal of Clinical Psychology. 2012;73:81.
  11. Bauer BA (expert opinion). Mayo Clinic, Rochester, Minn. July 2, 2012.
AN02087 Aug. 14, 2012

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