I've heard natural remedies for depression, such as St. John's wort, can work as well as antidepressants. Is that true?

Answer From Alastair J. McKean, M.D.

So-called natural remedies for depression aren't a replacement for medical diagnosis and treatment. And natural doesn't always mean safe. Yet, for some people certain herbal and dietary supplements do seem to work well. More studies are needed to find out which are most likely to help and what side effects they might cause. Talk with your healthcare professional about supplements and whether they're right for you.

There are many different supplements that are promoted by marketers as helping with depression. Here are some common examples:

  • St. John's wort. This herbal supplement is not approved by the U.S. Food and Drug Administration (FDA) to treat depression in the U.S. St. John's wort may be helpful for mild or moderate depression, but use it with caution. St. John's wort can interact with many medicines. A few examples include blood-thinning medicines, birth control pills, chemotherapy, HIV/AIDS medicines and medicines to prevent organ rejection after a transplant. Also, do not take St. John's wort while taking prescription antidepressants. The mix can cause serious side effects. St. John's wort may trigger mania in people with bipolar disorder.
  • SAMe. This dietary supplement is a synthetic form of a chemical that occurs naturally in the body. SAMe, pronounced sam-E, is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe is not approved by the FDA to treat depression in the U.S. More research is needed to find out if SAMe is helpful for depression. In higher doses, SAMe can cause upset stomach and trouble passing stool. Do not use SAMe if you're taking a prescription antidepressant. The mix may lead to serious side effects. SAMe may trigger mania in people with bipolar disorder.
  • Omega-3 fatty acids. These fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression and for depressive symptoms in people with bipolar disorder. Mania has been reported in some people with bipolar disorder who take omega-3 supplements. Omega-3 supplements are generally considered safe. The supplements can have a fishy taste. In high doses, they may interact with other medicines. Eating foods with omega-3 fatty acids appears to have heart-healthy benefits. More research is needed to find out if omega-3 fatty acids can make depression better or if they can keep depression from happening.
  • Saffron. Saffron extract may make symptoms of depression better, but more study is needed. While saffron is likely safe in doses usually found in food, saffron may cause upset stomach, vomiting and headache. Higher doses can cause serious side effects, such as bleeding problems and interactions with other medicines. Also, higher doses can be dangerous during pregnancy.
  • 5-HTP. The supplement 5-hydroxytryptophan (hi-drok-see-TRIP-to-fan), also known as 5-HTP, may play a role in raising serotonin levels. Serotonin is a chemical that affects mood. But evidence is early and limited, and more research is needed. There is a safety concern that using 5-HTP may cause a severe neurological condition, but the link is not clear. Another safety concern is that taking 5-HTP with some prescription antidepressants could raise the risk of serotonin syndrome, a serious side effect.
  • DHEA. Dehydroepiandrosterone (dee-hi-droe-ep-e-an-DROS-tur-own), also called DHEA, is a hormone that your body makes. Changes in levels of DHEA have been linked to depression. Several early and limited studies show that depression symptoms get better when taking DHEA as a dietary supplement, but more research is needed. DHEA is usually well tolerated, but it has possible serious side effects. This is especially a risk if used in high doses or long term. DHEA made from soy or wild yam is not effective.

Nutritional and dietary supplements are not monitored by the FDA the same way that medicines are. You can't always be certain of what you're getting and whether it's safe. It's best to do some research before starting any dietary supplement. Make sure you're buying your supplements from a reputable company. Find out exactly what the supplements contain.

Also, because some herbal and dietary supplements can interact with prescription medicines or cause dangerous side effects, talk with your doctor or other healthcare professional before taking any supplements.

With

Alastair J. McKean, M.D.

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Dec. 20, 2024 See more Expert Answers

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