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Re: SJW should be first AD tried

Posted by Larry Hoover on February 22, 2003, at 7:41:25

In reply to SJW should be first AD tried, posted by Lawrence S. on February 21, 2003, at 1:44:40

> St Johns Wort has reduced anxiety, anhedonia, anger and deppresion as effective as any ssri I have ever tried. It seems to take the edge off of every symptom while enhacing cognition and memory, without any side effects. I wish it would have been available when I was first experiencing these maladys before ethey reached the severe stage. Still, I would'nt rule it out for severe deppression. I think it works too. By reducing the severity.

The real issue with SJW for more severe symptoms of depression is dose, just as with any antidepressant medication. The *only* reason, in my studied opinion, that SJW has not been recommended for severe depression is that they didn't try a high enough dose to see if it worked. The standard dose is said to be 900 mg/day of 0.3% hypericin extract. There was one study that used 1800 mg/day on subjects with severe depression (HAM-D 27), and it worked as well as imipramine worked.

There is no upper dose limit to consider, other than individual side effects. SJW is not toxic. It has been used at doses of 22,000 mg/day (not a typo) as a possible AIDS therapy. SJW has anti-retroviral effects in vitro, but was ineffective in vivo.

Just as with any other antidepressant, it would make sense to up the dose until one of two things occurs: a) remission of symptoms; b) intolerable side effects.





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