Posted by Cam W. on August 15, 2000, at 21:53:11
In reply to St. John's Wort and Zoloft comparison and...CamW?, posted by dj on August 15, 2000, at 19:52:30
dj - Yes, SJW does work for "mild to moderate" depression, but not severe, atypical or psychotic depressions.
There are some interesting methodological problems with the first study cited:
1) The sample size of the study is very small (N=30), so it is hard to get any accurate statistics from the results.
2) The Zoloft dose is fairly low, with 100mg daily being a fairly standard adult dose.
3) Both SJW and Zoloft can take up to 8 weeks to exert their full effect. The study was only six weeks long.
4) I've always hated a 50% reduction in HAM-D scores as a measure of antidepressant efficacy. For example, if someone who is severely depressed and has a high HAM-D score, a 50% reduction can mean that the depressive symptoms are still significant. These patients, being outpatients, are probably not severely depressed, though.
5) There is no mention of how many people finished the study and how many dropped out. There is almost always an attrition rate in any study.
6) The response rates of both are rather low. You usually expect 2/3 of depressed people to respond to an antidepressant. Neither drug was particularily effective.
7) Was there a placebo arm to this study? It would be interesting to see how many placebo responders that there were.
I do not disagree that SJW and Zoloft work for mild to moderate depression, but I would want to use Zoloft for more severe depressions.
Herbal Combination of Ginseng and Ginkgo.
Long term studies recommend that ginseng be used no longer than 8 months. I can't remember the exact reason, but I think it had something to do with liver problems (I could be wrong).
Ginkgo does work, but you have to have decreased blood perfusion (widespread blood flow problems) to the brain to see any significant results with it. In other words you have to have cognitive deficits to notice any improvements when taking tha drug.
Really, is 7.5% a significant increase in cognitive function? The same could probably be done by doing crossword puzzles for a month. A portion of that would be placebo effect. Also, people often do better on cognitive batteries the second time they take them because they are more familiar with the format. This is probably (hopefully) minimized with FDA-approved cognitive batteries.There are probably some slight, but noticeable gains in some people. The 7.5% is an average. This means that some people could have had a decrease in cognitive function.
I do not have a problem with herbal products in general. It is just that many people equate natural with safe and this is dangerous. Anything one takes to alleviate or prevent a medical condition must be considered a drug (even water, when used to flush out the cold virus) and all drugs (even water) have risks. This is especially the case when one mixes herbs with allopathic (convensional) drugs. We still do not know all of the interactions that can occur. Also, most people do not tell their doctor of herb use and this can also lead to drug-herb interaction problems or efficacy problems.
One last comment. Yes, many herbs do have a medicinal effect, but look at the price one pays for them. Most herb companies do not do much, if any, testing of their product, yet herbs are as expensive (sometimes more) than tested and effective allopathic medication. Where does this cost saving on the part of herbal companies end up? In the pockets of the owners and shareholders of herbal companies. And you thought that multinational drug companies were the only crooks.
The views expressed by this poster are his own and cannot be generalized to the entire medical (or herbal) community ;^) - Cam
poster:Cam W.
thread:43007
URL: http://www.dr-bob.org/babble/20000811/msgs/43019.html