... 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).

[Minifingers]

Yegods - have had repeated visits to GP re: low ferritin levels. Have had lots of blood tests. No auto-immune disorder. Or anything else indentifiable, other than hypothyroid (and yes, I know SJW can reduce levels of thyroxine in the blood - I am being careful about how I take my meds and closely monitoring symptoms. If my thyroid symptoms get worse I will reconsider the SJW. At the moment my energy levels etc are better than usual).

[SackAndCrack]

Are you treating the low ferritin levels?

[PlentyOfPubeGardens]

This is a good site for info and support.

[Minifingers]

Yup - with spatone and diet. The supplements given my by the doctor didn't stay in my body long enough to be absorbed I reckon - took them for months and all they did was give me the squits!

[yegodsandlittlefishes]

So no auto-immune disease... apart from Hashimotos then? (Look it up, unless you ask for it, GPs do not test for it, just test how the pituitary thinks the thyroid is doung). That can give you depression too.

Like others have said, I am glad you have found something that works for you for now. If you do have Hashimotos the symptoms are going t get worse and you'll have fewer and fewer hyperthyroid spells. You can get prescribed medication for the hypothyroidism and with the iron tablets/liquid you would feel well again.

I've got Hashimotos and anemia and so I really do know how it feels, and I have also refused to take ADs when they have been prescribed to me, yes I can identify with your decision making. Low vitamin D can go arm in arm with the low thyroid function and related problems. I wonder if that is because so many with these symptoms take SJW and stay out of the sun!

I'd also say be careful about suggesting everyone who has depression should turn down Prozac and take SJW. I know people with MH illnesses for whom Prozac and other ADs are a life saver. I think we need to be careful here not to put a slur on MH illness and effective treatments of a different set of conditions just because ADs are not best for you and me.

[Minifingers]

No Hashimotos. Take vitamin d supplements. Hypothyroid symptoms have been stable for quite some time.

I am perimenopausal and living with a lot of stress, which I am acknowledging and trying to address.

3 weeks ago I put my hands up and said 'I can't go on like this' - I was so tearful, low and angry. I felt duty bound to go to the doctor as my low mood was making me shouty and hateful to the family. Since starting on the SJW I feel back in control of myself. Which is great!

[yegodsandlittlefishes]

That is great. Glad that you found something that works for you. Other things do work for other people though, which is why they exist.

[Jollyphonics]

Why do people keep saying that GPs are paid to prescribe things? Prescribing costs money, we get no benefits for it other than the QOF points we achieve by lowering patients BP, cholesterol with drugs etc. The only people who make a single penny out of prescribing are the drug companies and the chemists who dispense the drug. Oh and the manufacturers of the paper that the prescription is made of.

[quirrelquarrel]

You mean pharmacists? They don't make money out of prescriptions.

[quirrelquarrel]

But quite happy to be corrected on the other front!

[IwinIwin]

SJW can be hard to find the appropriate dose to help someone OP, also if you don't buy a 'good' version - regulated version with THR stamp on it- then really you have no idea what shit is in it. Even worse is if you are using a food supplement because there's no regulation there.

I like herbal medicines but you have to be aware that a) the dose is generalised b) there's a possibility of attenuation which is really more likely in unregulated versions of it and c) the best ones to buy are those with THR stamp, because i's had more quality control, the food supplements have none.

Also to bear in mind (and I'm a SJW advocate here) is that some peopel are allergic to components of the plant (luckily you aren't) since it's the whole plant used and when weaning off it or stopping usage the depression can return at much higher intensity.

There is a drive to use more HM, in the UK.

www.mhra.gov.uk/Howweregulate/Medicines/Herbalmedicinesregulation/

[FreudiansSlipper]

a week is very quick to feel such a difference, the mind is very powerful if we believe something is going to make a difference

mental health and medical model go hand in hand now, thankfully many are questioning the influence that the pharmaceutical companies are having in this involvement

i guess gp's do not really have the time to go through all the options, ad's are shown to work well to help with anxiety and depression but not to cure it, that costs a lot more time and money (not necessarily cure it)

[mymiraclebubba]

I agree with Freudian a week is a very fast turn around for anything especially herbal remedies to have any sorting effect like you are describing! I would be wary that it's not a psychosomatic reaction to expecting st John's wort to work.

As a sufferer of chronic depression and anxiety I have never found it to help tbh and am prepared to suffer a lower libido in order to feel better in myself which in turn allows my libido to increase on it's own.

Gp's know it isn't often effective in chronic depression sufferers.

[bobot]

Because SJW isd a weak SSRI. It isn't licensed, they can't prescribe it, the production is unregulated and there is little evidence on effective / therapeutic doses. Some people find that the older tricyclics are less troublesome in terms of side effects than SSRI's - other people find the opposite.

[schlurplethepurple]

GP's dont have time to go through options?

A) SJW is not a recommended option and
B) Today's consultation models are all about giving patient options!

[FreudiansSlipper]

i said all the options

i have sat in a gp's off many times (different gp's) describing my symptoms and been told i am suffering depression

i have an underactive thyroid, while it can cause you to feel depressed i was not depressed thankfully one doctor sent me for a full thyroid screening

if i had seen another gp i may once again have been told i am depressed

[80sMum]

Some very interesting posts here.

I was recommended to try SJW by a doctor (during a private health assessment through BUPA) and, as I mentioned earlier, have taken for about 7 or 8 months of every year since 2005.

I am surprised to read that many people find an almost instant effect from SJW. I have found that it takes about 3 weeks to 'kick in' so I always start taking it at least a month before the clocks change in autumn (my problem is SAD).

[Jollyphonics]

Pharmacies are paid to dispense prescriptions. Not the individual staff member obviously, but the pharmacy owner gets money for each prescription. Just for info.

[WidowWadman]

" Pharmaceutical companies do not make much from selling natural/homeopathic medicines

That is the ONLY reason"

So who is producing all these sugar pills and herbal concoctions? They are produced to generate a profit. That profit might not go to GSK but to Weleda or Holland and Barrett, but you're a fool if you believe that they're in for the love of it alone and not to make a profit.

[WidowWadman]

80ies - instant effect is most likely down to placebo. I was prescribed it about 15 years ago (back in Germany) and was told to expect it to take about 6 weeks to show an effect. Whether the getting better was down to the medication, or me just getting better on my own of course wasn't discussed (and in any case, it didn't do it for me and I went on to SSRIs and other ADs

[Minifingers]

6 weeks is how long you're advised to wait to assess efficacy but many many people feel improvements before this. Same with SSRI's (longer actually). But I have felt improvements in mood in a week with both SSRI's and SJW.

[quirrelquarrel]

I work in a pharmacy and I asked our pharmacist a while ago what they got for handling prescriptions and he said nowt

[Jollyphonics]

He wouldn't have got anything apart from his basic salary, unless he owned the pharmacy. Did he own it or just work there?

[quirrelquarrel]

He said the pharmacy doesn't get anything.
He works there.

[Minifingers]

I'm surprised at the consistent refusal of many people on this thread to take any notice of the findings of a Cochrane review on SJW (linked to earlier). This review found evidence of efficacy in relation to mild and moderate depression and fewer side effects than standard SSRI's including fluoxetine and citalopram. This review looked at 29 trials involving 5489 patients.