... In wondering why gp's don't even mention St. John's wort for depression?

(192 Posts)
Minifingers Sat 08-Mar-14 22:53:55

Been feeling very tearful, weird sleep patterns, shouty, negative, hopeless for a few months now for reasons mostly to do with family strife. Recognised that I was tipping back into a depressed state similar to one I was in a few years ago. Went to gp and asked if she could prescribe me a low dose of an AD which wouldn't make me fat and make sex rubbish. She said 'no - they almost all do this to a lot of people, and gave me a prescription for sertraline.

Anyway, after reading up about the side effects and thinking about how horrible it is when you start taking AD's I started to feel very reluctant to take them. Decided instead on the recommendation of a friend to give St. John's wort a go instead after doing a bit of research on its safety and effectiveness. Seems that in Germany it's often prescribed by gps for mild/moderate depression in preference to SSRI's and is considered completely mainstream.

Anyway, low and behold it's worked really well - a week on I feel so much better. Much less tearful, just miles better.

Why don't gps even mention it to those of us who haven't got any specific health reasons not to use it and are not on other non-compatible meds?

I'm amazed by how effective it is - for me as good as fluoxetine which I used a few years ago for a few months when I was depressed. And no unpleasant side effects that I'm aware of (I'm staying out of the sun).

ethelb Sat 08-Mar-14 22:57:46

Lots of side effects including making pill ineffective.

WorraLiberty Sat 08-Mar-14 22:58:19

Some GP's do...I know mine does because my friend was quite offended (we share the same GP) when it was suggested to her.

I think she thought the GP didn't believe she was truly depressed

But I think the GP was just suggesting an alternative so she could see how she got on with it.

mousmous Sat 08-Mar-14 22:59:49

because it has many side effects and should not be taken together with many medicines (contraceptive pill is one that doesn't work propely together with it!)

it is very potent, though, and if it works for you then it's great.

nostress Sat 08-Mar-14 23:03:31

Yes evidence says as good as prozac but not without side effects

StarGazeyPond Sat 08-Mar-14 23:04:27

And it shouldn't be taken if there is ANY chance of epilepsy/seizures.

Minifingers Sat 08-Mar-14 23:05:45

"Lots of side effects including making pill ineffective."

The majority of adults are not using hormonal birth control.

And have you seen the side effects linked to setraline?

Side-effects

Very common: More than 1 in 10 people who take Sertraline hydrochloride
difficulty sleeping
dry mouth
feeling dizzy
nausea
sexual dysfunction including ejaculation problems or erectile dysfunction. Sexual dysfunction may affect men and women
sleepiness
tiredness
withdrawal symptoms can occur when this medicine is stopped. These include feeling dizzy, paraesthesiae, difficulty sleeping, strange dreams, feeling agitated or anxious, nausea, vomiting, tremors or headaches
Common: More than 1 in 100 people who take Sertraline hydrochloride
appetite gain
chest pain
constipation
decreased libido
depersonalisation
depression
eye or eyesight problems
feeling anxious
feeling nervous
flatulence
hot flushes
increased muscle tone
indigestion
loss of appetite
musclepain or tenderness
nightmares
palpitations
paraesthesiae
pharyngitis
skin rash or rashes
stomachpain
taste changes
teeth grinding
tinnitus
vomiting
yawning
Uncommon: More than 1 in 1000 people who take Sertraline hydrochloride
abnormal thoughts or feelings
apathy
back pain
belching
bleeding problems such as unexplained or easy bruising of the skin or mucous membranes, nose bleed, gastrointestinal bleeding or blood in the urine - some of these bleeding problems may be fatal
breathing difficulties
bronchospasm
changes to weight
chills
cold sweats
convulsions
coordination problems
dry skin
ear pain
euphoria
faster heart rate
fever
flushing
general feeling of being unwell
haemorrhoids
hair loss
hyperactivity
hypoaesthesia
increased salivation
migraine
muscle contractions
muscle twitching
muscle weakness
oesophagitis
osteoarthritis
passing much more urine than usual
raised blood pressure
respiratory tractinfection
rhinitis
speech problems
swallowing difficulties
swelling around the eyes
thirst
tongue problems
unexplained or unexpected increase in muscle movement
urinary problems
urinary retention
urinating more often at night
urticaria
vaginal bleeding - this may be fatal
weakness
Rare: More than 1 in 10,000 people who take Sertraline hydrochloride
abnormal gait
abnormal laboratory test results
abnormal muscle movements or problems controlling muscle movement
abnormal smell of the skin
behavioural problems such as feelings of hostility, anger, aggression, thoughts of committing suicide or suicidal tendencies - you or your carer must seek immediate medical advice if you have behavioural changes, thoughts of committing suicide or have attempted to commit suicide. Thoughts of committing suicide or suicidal behaviour may also occur soon after stopping treatment with Sertraline hydrochloride
blood in the stool
bone problems
certain types of dermatitis
coma
conversion disorder
decreased blood sugar levels
difficulty speaking
dose tolerance decreased
double vision
ear infection
enlargement of the pupil
faster breathing rate
feeling paranoid
galactorrhoea
gastroenteritis
gastrointestinal problems
genital discharge
glaucoma
hair problems
heart attack
heart or circulation problems
heavy or long menstrual periods
hernia
hiccups
high levels of cholesterol in the blood
hypersensitivity to external stimuli such as light, noise and physical contact
hypoventilation
inflammation or infection of the mouth or tongue
injury
irritation or inflammation of the penis and foreskin
irritation or inflammation of the vagina and vulva
lymphadenopathy
melaena
mouth or tongue ulcers
neoplasms
over-sensitivity or fear of light
priapism
psychosis or psychotic-like behaviour or worsening of psychosis or psychotic-like behaviour
semen abnormal
sensory problems
Sertraline hydrochloridedependence
sleep walking
slower heart rate
spasms of the throat
stridor
tooth problems
urinary hesitation
urinary incontinence
urinating less or less often
vasodilation procedure
The frequency of these side-effects is unknown
allergic or anaphylactic reactions
angioedema
blood problems
blood sugar control changes in diabetics - people with diabetes may be advised to adjust their anti-diabetic therapy
breast enlargement in men
cerebrovascular problems
diabetes
extrapyramidal side effects such as hyperactivity, increased muscle tone, abnormal muscle movement, teeth grinding or abnormal gait
face oedema
feeling restless and inability to sit still
increased blood sugar levels
increased pressure in the eye
irregular menstrual periods
itching
jaundice
jointpain
liver problems
lung problems
mania or mania-like behaviour - seek medical advice if you get mania or mania-like behaviour
may affect the results for certain tests
metabolic problems - some metabolic problems may be fatal. Seek medical advice if you develop headaches; concentration or memory problems; weakness; unsteady movement which may lead to falls; hallucinations; fainting or brief loss of consciousness or respiratory arrest
muscle cramps
neuroleptic malignant syndrome or serotonin syndrome - symptoms may include a fever, rigidity, confusion, feeling agitated, sweating excessively or diarrhoea
oedema of the extremities
pancreatitis
photosensitivity skin reaction
seizures - you or your carer must seek medical advice if you have seizures or there is a change in seizure frequencies
Stevens-Johnson syndrome
strange dreams
thyroid problems
toxic epidermal necrolysis"

BumpyGrindy Sat 08-Mar-14 23:06:23

Ooh I think I will get some! Thanks for the heads up OP and glad it's working for you.
My DH could do with it too...neither of us has any other medication....is it expensive?

BumpyGrindy Sat 08-Mar-14 23:07:13

Mini are those side effects just for people who take the medicine you mention?

Egusta Sat 08-Mar-14 23:07:24

Really, the majority of adults are not using hormonal birth control?

who claims that?

idlevice Sat 08-Mar-14 23:07:34

I was told recently by a mental health nurse something along the lines of how St John's Wort has several different effects on brain chemistry whereas an AD has been optimised to just have the one targeted effect so there is a higher probability of success with ADs.

Ignaz Sat 08-Mar-14 23:10:03
Minifingers Sat 08-Mar-14 23:10:36

"Mini are those side effects just for people who take the medicine you mention?"

Those are the common, less common, and rare side effects of Sertraline. They are similar to the side effects and risks associated with most SSRI's currently prescribed by GP's.

memyselfandl Sat 08-Mar-14 23:11:01

There are also issues that different manufacturers put different ingredients/doses into St Johns wort. It is a herbal medication that does interfere with a lot of medication--not just contraceptive pills and as ingredients are not always known-the GP cannot recommend in good faith that it will not do more harm than good

MyChildDoesntNeedSleep Sat 08-Mar-14 23:11:48

Yes but the ADs doctors prescribe are licensed medicines and so have been rigorously tested and monitored. This is why we have such a comprehensive idea of possible side effects etc. Herbal medicines like SJW are unlicensed and so the doctor will be taking responsibility if something were to go wrong. It is also not recommended by the main drug reference book doctors use or endorsed by NICE, so a GP couldn't really justify using NHS resources for such a product.

Logg1e Sat 08-Mar-14 23:11:51

Something tells me that this wasn't just an idle wondering.

CheeseStrawWars Sat 08-Mar-14 23:12:34

On rough maths, 50% of adults are male, so not on hormonal birth control. I'm surprised at anyone who claims the majority of adults are using hormonal birth control, as the remaining 50% female adults are not all of child-bearing age.

BumpyGrindy Sat 08-Mar-14 23:14:17

What if like me, you're not on birth control or any other medication? Would it not be fine to try it in my case?

oohdaddypig Sat 08-Mar-14 23:17:04

Because drug companies don't make much money from it?

Great it's worked for you OP

Minifingers Sat 08-Mar-14 23:17:22

But with respect Ignaz, there have been good quality randomized trials which have also thrown doubt on the effectiveness of SSRI's.

This Cochrane review of the evidence seems to suggest St Johns wort may be helpful for mild to moderate (not severe) depression. here

Latara Sat 08-Mar-14 23:18:16

Minifingers - how long did it take you to type out those side effects?!

I'm on AD's and antipsychotics and anticonvulsants - I have to have regular blood tests and ECGs, I daren't even read the side effects!

I think SJW isn't promoted by GPs because it's probably not had the correct kind of research done on it, it's risky for some people like with epilepsy too.

It's not what you want to hear, but: Take the Sertraline for a few weeks; you will soon feel better. Don't focus on the side effects too much. Hope your depression improves.

80sMum Sat 08-Mar-14 23:19:09

I have been talking SJW every winter for the past 9 years now. I am convinced it has a strong stabilising effect on my mood, it lifts me out of myself and stops me sliding into a gloomy and depressed state. I start taking it in mid September and slowly ease back the dose in April, so that by mid May I have weaned myself off it. I find that I can get by without it in the summer, providing I can get outside most days.

Piscivorus Sat 08-Mar-14 23:19:27

All medicines have side-effects but licensed medicines have them listed and quantified, just as you have seen for sertraline. St John's Wort has not been tested the same way, that does not mean there are fewer side-effects just that they are less researched.

St John's Wort does have huge and potentially lethal interactions with other medicines due to its effects on liver enzymes so should not be taken without proper advice.

Minifingers Sat 08-Mar-14 23:19:35

"We have reviewed 29 studies in 5489 patients with depression that compared treatment with extracts of St. John's wort for 4 to 12 weeks with placebo treatment or standard antidepressants. The studies came from a variety of countries, tested several different St. John's wort extracts, and mostly included patients suffering from mild to moderately severe symptoms. Overall, the St. John's wort extracts tested in the trials were superior to placebo, similarly effective as standard antidepressants, and had fewer side effects than standard antidepressants. - See more at: http://summaries.cochrane.org/CD000448/st.-johns-wort-for-treating-depression.#sthash.LsCX8MD4.dpuf

BumpyGrindy Sat 08-Mar-14 23:20:23

Latara I am sure she copied and pasted grin

Can anyone Mini advise...if you don't take birth control or ANY other medication...is it safe to try St John's?

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