Miami Herald - Thursday, May 25, 2000
Christine Morris

The popular herbal supplement St. John's wort is ineffective as a treatment for depression, according to results of a national study conducted at the University of Miami and 10 other medical centers.

"Don't waste your money is the bottom line here," said Dr. Paul J. Goodnick, the UM psychiatrist who conducted South Florida's part of the study.

The study sought to determine the herb's effectiveness in patients with major depression. Each of the 201 participants nationwide suffered from at least five symptoms in a list including changes in sleep or appetite, memory disturbances, inability to concentrate, agitation, fatigue and feelings of guilt or worthlessness.

Participants were screened carefully and then given St. John's or a placebo for eight weeks. Tests were conducted throughout the study to determine the status of the patients' depression.

The results were similar for both groups and did not show significant improvement, according to the study, which was presented at last week's meeting of the American Psychiatric Association in Chicago. The drug company Pfizer, which makes antidepressants but does not produce St. John's wort, underwrote the research.

The supplement became popular after studies in Europe, where it is widely prescribed, suggested that it eased depression and had only moderate side effects. But the studies were not done to U.S. standards, the kind of measures applied to experimental drugs for other diseases, according to the National Institutes of Health.

Denise Bozarth of Homestead, a participant in the study at UM, was given St. John's wort. "It didn't even affect me really," she said. "I didn't really see any changes at all. I was still having mood swings and just crying for no reason." Bozarth, 27, is taking other medication now and says she is doing very well.

Concern also is growing about possible complications from the supplement. Studies published earlier this year found that St. John's wort interferes with the effectiveness of indinavir, a drug used to treat HIV patients, and with cyclosporin, a drug used in transplant patients. The herb also has been shown to cause sensitivity to light and may reduce fertility, said Goodnick, professor of clinical psychiatry and behavioral sciences and director of UM's mood disorders program.

"St. John's has taken over," Goodnick said. "It doesn't require a prescription, it's cheap, you don't have to see a doctor, you don't have a medical record. A lot of claims were made left and right that were never substantiated.

"We needed to show that it's not something you take for the heck of it," he said.

But the earlier studies suggesting its effectiveness -- without significant side effects -- have made the supplement immensely popular.
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