In the United States, it seems as though the number of diagnosed cases of
depression seem to be growing exponentially each year, and furthermore, it seems
as though anti-depressants are prescribed as a catch-all for many illnesses unrelated
to depression, such as fibromyalgia, obesity, PMS, or other off-label uses. Lexapro
(escitalopram) is the 5th most commonly prescribed drug in the U.S. This drug
belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRI’s),
and as the name suggests, these drugs inhibit neuronal reuptake of serotonin, with
little or no effect on epinephrine or norepinephrine, to elevate mood. While SSRI’s
can alleviate symptoms of depression after several weeks of use, they also come
with a whole bundle of side effects, including insomnia, constricted pupils, dry
mouth, somnolence, dizziness, sweating, constipation, fatigue, sexual dysfunction,
and a black box warning of increased risk of suicide. For many, these side effects
are just too numerous, and too serious to deal with, so an herbal alternative for
depression is often the best choice to battle depression.
One of the most common herbs known amongst the mainstream population for
treating depression is St. John’s Wort. But what many people aren’t aware that St.
John’s Wort is actually a Chinese herb named Guan Ye Jin Si Tao (Herba Hyperici
Perforati). This herb is a bitter, warm, astringent herb that dispels wind-dampness,
and reduces swelling and toxins. Classically, this herb is used topically to treat
carbuncles, snake and insect bites, and internally to treat bi-syndrome. However,
modern studies show that this herb also has an effect on serotonin levels in the
body, much like an SSRI, but without the serious side effects. Hyperforin, the main
active compound in this herb, works primarily by increasing the level of serotonin,
and secondarily by inhibiting the enzyme monoamine oxidase (MAO), which is what
another class of anti-depressant drugs (MAO Inhibitors) are targeted to do. Not only
does Guan Ye Jin Si Tao act on the serotonin, but it also affects the reuptake of other
neurotransmitters such as norepinephrine and dopamine.
Since St. John’s Wort acts like an SSRI, it can be used to help a patient decrease the
dosage of their meds, if they wish to come off the drug gradually. It must be done
with caution, and under the care of a licensed health care professional, because
concurrent use of both the drug and the herb could lead to “serotonin syndrome”
with symptoms such as sweating, tremor, flushing, confusion, and agitation.
Therefore, dosage of both the drug and the herb must be monitored carefully.
If someone is to stop an SSRI abruptly, they may experience electrical shock
sensations in their head (also known as brain shivers, or brain zaps), dizziness, and
bladder control issues. Using the herb St. John’s Wort can help someone to gradually
taper off their medication, and decrease the likelihood of withdrawal signs and
symptoms. When combined with an herbal formula to treat the root problem of the
patient’s depression, Guan Ye Jin Si Tao can be used to effectively elevate mood, as
well as help a patient taper off their medication with fewer side effects, making it
invaluable in the treatment of mild to moderate depression.