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

[Minifingers]

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).

yep - homeopathy is usually pretty safe. unless what is being treated actually needs some effective treatment. The problem with pharmacologically active herbs in plant form is that they often contain all sorts of toxic shit.

I have used high strength sjw and it's only side effect is to remove the black cloud that sometimes follows me all day from over my head.

I find it amazing when u need it - and can use it for a few days then not feel I need it for weeks or months / incredible stuff

St Johns Wort isn't a homeopathic remedy.

And yes, some herbal medicines are not safely prepared and don't contain the appropriate amount of active ingredient.

"The problem with pharmacologically active herbs in plant form is that they often contain all sorts of toxic shit."

Can we have a reference for this assertion pls? As you use the word 'often'.

"I suppose the reason SJW isn't prescribed/suggested to everyone above traditional ADs is that it's simply not suitable for every case of mental illness, and interacts with other medications. That's why your doctor will look at your symptoms and suggest the most suitable AD they believe is available. No conspiracy."

But I'm also a suitable candidate for SJW.

Nigella's dealer GPs are not paid per prescription .... ! They are paid to minimise unnecessary prescriptions. Are you thinking of QOF payments?

Minifingers did you read my post on why GPs don't recommend it? Because it was quite comprehensive and very clear.

frozen i am not sure what the payments are called but they do exist, that is why doctors love prescribing stuff people do not need, eg statins.

In plant form, they contain everything that is in the plant. In some cases, it's a lot more than the active ingredient you hoped for . There is also no control over the concentration of the pharmacologically active compound if you consume the actual plant directly. Digoxin is a good example - the second year's growth is needed for that, but there is no guarantee of concentration, and high doses are often toxic. Salicylic acid from willow bark is a great example of an early analgesic that had horrific side effects until chemically modified to a form that had slightly less drastic side effects (aspirin).

For all its natural appeal, SJW is not benign, any more than cannabis or tobacco, two other "natural" herbs with pharmacological effects, are. SJW even interacts with other drugs of "natural" origin.

GPS are NOT paid per prescription.

Any drug with effects will have side effects. The reason homeopathy has no side effects is because it has no effects except the placebo effect. Absolutely take what works but bear that in mind.

FWIW I had IBS and the GP suggested peppermint, which worked wonders. I think a lot depends on your GP and his/her relationship with you. Mine had had a few conversations about drugs with me and was aware that I didn't want to take anything for long or without very good reason.

Nigellas my other half is a salaried GP (i.e. receives a set salary per year, like the rest of us) and I work in public health research with GPs. I know the payment structure well and they are not paid by prescription. Each prescription, remember, costs the NHS money not the other way around. This is why GPs prefer not to prescribe, for instance, a pack of paracetamol which the patient can buy for 22p but which would cost the NHS - with pharmacy dispensing costs - closer to £20.

The payments received under the QOF framework to the SURGERY, not the doctor (!), are to do with offering the patient the nationally recommended minimum standard of care for their condition. In some cases, they will be offered statins. Believe me, GPs do not love prescribing anything, and this would include statins. Most GPs just want to get through the consultation without being threatened, berated or making the patient unhappy, unnecessarily worried or angry (GPs are essentially people, after all).

OK I stand corrected, you obviously know more about it than I do.

No problem, sorry for going on at such length. I just wanted to explain it all as I realise it's very a bit complicated

In the interest of balance, my GP recommended I take SJW.

Advised me clinical trials had proven it's effectiveness for mild/moderate depression.

lovely safe medicinal herbs

yep, not safe to assume that plants are automatically safe

Nigella - a lot of statins have been recalled recently. My dad was taken off his because his local PCT was no longer supporting them.

I should point out that the 22p paracetamol isn't going to work as well as the £1.76 stuff in the whizzy branded packet. Expensive drugs, flashily branded, have a MUCH stronger placebo effect than cheap, unbranded generics. Even if you know about and understand the placebo effect.

(I've actually had a mild bout of allergic asthma sorted out during an asthma nurse consultation by an active-ingredient-free placebo inhaler which was clearly marked 'placebo'. I'm still laughing at myself three years later.)

Though the same can be said for dicolefenac, which has been withdrawn by many pcts because of severe cardiac side effects - at about the same time that it became licensed for OTC purchase.

25p paracetamol (yes, it's recently gone up in Sainsburys) works as well as it needs to for me, Kisses. I find paying 22p per tablet for such a simple drug quite painful, in itself.

(Also, Morrisons own-brand cetirizine, chemically identical to and probably made in the same factory as tesco's own-brand cetirizine, works far better for me. Because I like Morrisons and don't like tesco. So the placebo part of their effect is stronger. I long for the day when I achieve the level of self control needed to get strong medical effects from tea and chocolate hobnobs.)

25p per paracetamol tablet? It's 50p for the whole packet at the corner shop, here!

Homeopathy is not woo MrsTP - as ouryve's links show, herbs can be very powerful. Homeopaths are quite often medical doctors who've trained in the use of herbs too. They will be able to ensure any consumption of herbs is safe. (PS some GPs will refer to a homeopath)

The pharmaceutical companies rule the world now. Yes, there probably are some cases where St. John's Wort isn't appropriate, but really that caveat applies to all medicines, doesn't it? We can't give aspirin to children or people who have stomach ulcers, but that is not a reason for it not to be prescribed.

I personally think that we shouldn't believe everything we hear or see, by it on one side of an argument or another, but the pharmaceutical companies now have major imput on medical training, so doctors in general are not going to prescribe or recommend anything that is not one of their products.

I tried SJW before I admitted to myself I needed proper help.
I may as well have been swallowing jelly babies.