Depression and St. John's Wort 🆙

What is Depression

La trough it is a psychopathological state marked by a decline in mood, by dejection and psycho-physical prostration.

there different forms of depression, partly differentiable on the different causes or contributing causes (based on organic lesions, concomitant general diseases, biological substrates such as neuromodulatory deficits, genetic and psychodynamic factors).

Depression is overt when 5 or more of the typical diagnostic symptoms are present at the same time for at least 2 weeks of observation:

Depressed mood for most of the day, almost every day, as reported by the subject or observed by others;
Marked decrease in interest or pleasure for all, or almost all, activities;
Significant weight loss, in the absence of a diet, or significant weight gain, or decreased or increased appetite almost every day
Insomnia hypersomnia almost every day;
Agitation or psychomotor slowing;
Fatigue or lack of energy;
Feelings of self-deprecation, or excessive or inappropriate feelings of guilt, almost every day;
Decreased ability to think or concentrate and difficulty making decisions
Recurring thoughts of death, recurrent suicidal ideation without making specific plans, or a suicide attempt or making a specific plan to commit suicide.

In the depression, next to sadness, resists, disinterest e lack of initiative, are often present in the subject feelings of insecurity, sense of unworthiness, restlessness ed anxiety; they are always present insomnia, decreased sexual desire, headache, dizziness, functional cardiovascular disorders.

Depression is an underestimated and under-diagnosed disease, which often becomes chronic and in 50% of cases results in relapses; it is a disease that affects both sexes and all ages equally, although the incidence is higher in the elderly.

The difficulty in diagnosing depressive syndromes lies in the objective difficulty in recognizing the symptoms as specific.

Traditional drug therapy is undoubtedly the most successful in the most severe forms of depression; consequently, it is clear that the Phytotherapy may find it undeniable difficulties of insertion in the therapeutic field of psychosis.

Medicines and Phytotherapy

Depression: role of phytotherapy and drugs

Alongside the severe forms of depression, where the causes are very complicated and difficult to treat, there are also mild or minor forms, often attributable to the patient's inner conflicts, such as difficulties in adapting or existential vicissitudes.

Herbal medicine is useful in these cases, since the malaise never reaches levels of total alienation (as in cases of severe depression) and the symptoms are easily recognizable and treatable (pessimism, irritability and discontent prevail in these people).

Depression needs to be cured by doctors e psychiatrists, but the minor forms can be successfully treated using herbal remedies who, through clinical and diagnostic tests, have been shown to have a positive feedback on the individuals treated.

Treatment of depressive syndrome is mainly based on the psychotherapy pharmacological therapy, which aims to increase the amount of neurotransmitters usable by brain receptors (MAOI; SSRI; SNRI; NASSA ...).

In mild forms of depression (mild-moderate depression), only some plants have actually proved capable of acting on the symptoms, thus bringing a benefit to the patient: first of all thehypericum, but still there Griffonia Rhodiola and adaptogens Panax Ginseng ed Eleutherococcus (used as a support).
These herbal remedies, with mechanisms of action attributable to the various phytochemical components or more often to the entire phytocomplex, can be prescribed and recommended at therapeutic dosages. for long cycles, bearing in mind the drug interactions and contraindications.

Hypericum - St. John's wort

Name: Hypericum perforatum
Family: Hypericaceae

Hypericum represents a real drug in treatment of mild depressions, which in some country finds use for this purpose only under medical prescription.
The parts of interest, used for phytotherapeutic preparations, are the leaves and flowering tops (application in the preparation of herbal teas: use 1-2 top teaspoons for 150 ml of boiling water; leave to infuse for 5-10 minutes, filter and drink for a period of several weeks in the morning and in the evening).

For further information: Hypericum: Properties

Hypericum: Active Principles

Among the active ingredients of hypericum we can mention:

Naphthodiandrones (hypericin and pseudohypericin);
Flavonoids (hyperoside, quercitrin, isoquercitrin, rutin);
Floroglucine (iperforina e adiperforina);
Xantoni;
Tannins;
Essential oil.

Hypericum: Effectiveness

L'hypericin is considered the main active ingredient in the treatment of depression, along with iperforina and ai flavonoids.
Hypericum extracts are superior to placebo in the treatment of mild to moderate depressive states and for this indication they are as effective as the conventional antidepressants.

Hypericum phytopreparate looks like inhibit reuptake of brain amines (serotonin and noradrenaline); methanolic extracts of hypericin and hyperforin inhibited the synaptosomal uptake of serotonin, noradrenaline, dopamine and GABA in vitro.

Hypericum: Indications

The therapeutic indications of hypericum are:

Symptomatic treatment of depressive states of mild to moderate severity;
External treatment of wounds, burns and ulcerations of the skin (hypericum oil).

The recommended daily doses (900 mg, or in any case from 600 to 1200 mg) for standardized hypericin extracts are equivalent to 0,2-2,7 mg of hypericin.
The effect of hypericum manifests itself after 2-4 weeks treatment (such as traditional drugs).

Effetti Collaterali

St. John's Wort: Adverse Effects

Dry extracts and mother tinctures are generally well tolerated, even by the elderly patient.

Minor side effects, including skin rash, nausea, asthenia, and restlessness, have been observed in a range ranging from 2,4 to 7,4% of patients treated.

The use of St. John's wort is not recommended during the pregnancy, puerperium and in pediatrics.

It is necessary to avoid the use of St. John's wort at the same time as the use of other synthetic antidepressants (eg tricyclic antidepressants and SSRIs), in order not to run the risk of "serotonin syndrome".

Hypericum is a potent inducer of the hepatic microsomal system (it induces the activity of cytochrome P450 isoenzymes), therefore the use of hypericum is not recommended when you are taking other medications of which it could reduce the efficacy (e.g. cyclosporine, theophylline, benzodiazepines, coltsfoot, ritonavir, saquinavir, oral contraceptives, anticonvulsants such as carbamazepine and phenobarbital, digoxin, anti-migraines and others).

With regard to the photosensitivity induced by the presence of hypericin, 2 cases have been documented in men: the first in a subject who used hypericum for 3 years, while the second in a 35-year-old woman who developed a neuropathy no better after 4 weeks of treatment specified; in both cases the symptoms subsided following discontinuation of treatment.
Other studies indicate that photosensitivity occurs at higher dosages than the recommended dose.

Among serious side effects, following the use of hypericum, some cases of "mania"(e.g. a 20-year-old patient with manic depressive psychosis - who had replaced the prescribed treatment for bipolar disorder with hypericum, at the commonly recommended dose of 90 mg / day - experienced an episode characterized by extreme agitation, irritability, anxiety and insomnia).