Beyond Prozac

Beyond Prozac

Julian Whitaker, MD

Prozac, Zoloft, Paxil, and other SSRI antidepressants are terribly dangerous drugs. Yet, according to the National Institute of Mental Health, more than 10 million Americans are treated with these drugs every year. This is insane—especially since there are a number of safe, natural therapies that have been scientifically proven to work every bit as well as prescription antidepressants.

Chase Worries Away With St. John’s Wort

One of the best-studied natural antidepressants is St. John’s wort (Hypericum perforatum). This herb raises levels of serotonin, a neurotransmitter involved in mood that is the target of Prozac and related antidepressants. However, the herb acts in a more subtle and much safer manner. Hundreds of clinical trials involving St. John’s wort consistently demonstrate that it not only relieves depression but is as effective as antidepressant drugs and much better tolerated.

In a recent study published in the British Medical Journal, German researchers tested an extract of St. John’s wort head to head against Paxil in a group of patients with moderate to severe major depression. The herb was found to be “at least as effective” as the drug. Furthermore, adverse effects such as gastrointestinal and nervous system disorders were almost twice as common in the patients taking Paxil as in those taking St. John’s wort.

Sensational SAMe

Another excellent therapy for depression is S-adenosylmethionine (SAMe). This natural amino acid metabolite, found in virtually every one of your cells, plays a critical role in methylation, a process which “turns on” genes that activate diverse biological functions, from detoxification to cartilage synthesis to neurotransmitter production.

According to a meta-analysis of studies on SAMe and depression funded by the government’s Agency for Healthcare Research and Quality, treatment with SAMe produces significant improvements in mood that are superior to placebo and similar to antidepressant drugs. Furthermore, it works much faster (a week compared to six or eight weeks for the drugs) and has only minimal side effects (headache or constipation compared to loss of libido, agitation, and increased risk of suicide and violent behavior with the drugs).

Down in the Dumps? Try DHEA

Natural hormone replacement therapy is also helpful for mood disorders, and, in fact, testing for imbalances in estrogen, testosterone, and especially thyroid and DHEA should be a first step in addressing depression. DHEA is particularly promising because, unlike other hormones, it is available as an over-the-counter supplement.

In one study, researchers from the National Institute of Mental Health enrolled men and women with midlife-onset major or minor depression in a double-blind placebo-controlled study in which they took DHEA for six weeks and placebo for another six weeks. Although it didn’t help everyone, DHEA improved depression scores by 50 percent or greater in those patients who did respond positively (roughly half the total group). These patients also reported improvements in sexual function.

The conclusion of this government-funded study? “We find DHEA to be an effective treatment for midlife-onset major and minor depression.”

If They’re Better, Why Aren’t They Used?

Given the efficacy and safety profile of these natural treatments, you might ask yourself why doctors in this country aren’t recommending them instead of antidepressants. In Germany, St. John’s wort is the leading therapy for depression and physicians recommend it far more often than antidepressant drugs. Why not here?

One reason is that in the US, physicians and patients alike are bombarded with advertisements for drugs. The pharmaceutical industry is a propaganda machine, spending over $16 billon annually advertising their wares to doctors and more than $4 billion advertising them directly to consumers. It pays off.

In a study published in JAMA, actors pretending to have either major depression or “adjustment disorder” (stress, fatigue, and insomnia: a very weak indication for an antidepressant) made 298 incognito visits to 152 doctors’ offices. At each visit they followed one of three scenarios: 1) They asked for Paxil, an antidepressant they saw advertised on TV; 2) they asked for any antidepressant; or 3) they made no drug request.

Here’s what happened. Of the actors with “major depression,” 53 percent in group 1 got a drug, as did 76 percent in group 2 and 31 percent in group 3. When they were portraying “adjustment disorder,” prescriptions were written for 55 percent, 39 percent, and 10 percent, in groups 1, 2, and 3, respectively. Overall, Paxil was prescribed for 32 of 100 requests for this specific drug, compared to only 6 of 99 requests for any antidepressant.

An Unlevel Playing Field

Another reason natural therapies aren’t recommended by most docs in the US is because the deck is stacked against them. You won’t see ads touting SAMe, St. John’s wort, or DHEA as a treatment for depression on TV. The FDA forbids it. Why? Because, except in a handful of cases, manufacturers can’t provide scientific evidence showing that nutritional supplements effectively treat diseases.

This decree is absurd and illegal, but the FDA does it anyway, and Congress lets them get away with it. The only plausible reason for this shameful behavior is that if physicians and patients truly understood the advantages of nutritional supplements, there would be a mass exodus away from drugs. That just wouldn’t do for the pharmaceutical giants who control both the FDA and physicians.

There are 1,274 registered pharmaceutical company lobbyists in Washington—more than double the number of members of Congress. Drugmakers have spent $758 millon lobbying since 1998, more than any other industry, and their private jets are available for use by “friendly” Congressmen, whose campaign coffers are lined with drug company donations. Now, don’t tell me this doesn’t make a difference.

“I Have My Life Back”

I want to close by telling you about one of my patients. Several years ago, Claudia began having nighttime episodes of a racing heart, difficulty breathing, and strange sensations in her body. It kept her up for hours obsessively taking her pulse, convinced that she was going to drop dead of a heart attack at any minute.

When these “attacks” started coming on during the day, she went to see her HMO doctor, who promptly prescribed Paxil. Claudia found it odd that she received an antidepressant, but believing that “doctor knows best,” she didn’t argue. That’s when her problems really began.

“The side effects were horrible. I felt like a walking zombie. Zero interest in my friends, family, work, intimacy. You name it, it was dead to me. And if I wasn’t depressed before, I sure was then. It was awful. The worst part? I lived like this for three years. Thank God I found the Whitaker Wellness Institute when I did. I learned that there are safe, natural ways to curb anxiety and that prescription drugs are not only dangerous but they literally wipe out the essence of who you are. I was weaned off Paxil and for the last year I’ve been taking herbs and amino acids. I feel great, my anxiety and panic attacks are under control, and I can honestly say I have my life back.”

Recommendations

  • The suggested dose of St. John’s wort is 300 mg three times a day. This herb lessens the effects of some drugs and should not be taken with statins, digoxin, oral contraceptives, Coumadin, or Prilosec, as well as some drugs used by patients with psychosis, organ transplants, HIV infection, or who are undergoing chemotherapy. The product used in the Paxil study was Perika by Nature’s Way.
  • SAMe should be taken in a dose of 200–400 mg twice a day on an empty stomach. It should not be taken by anyone who is suicidal or has bipolar disorder. SAMe is also helpful for arthritis and liver disease. Look for it in your health food store or order it from Whitaker Wellness at (800) 810-6655.
  • The DHEA dose used in the depression study was high, 90 to 450 mg daily. However, it was well tolerated, the only side effects being oily skin and acne. I would suggest starting at a much lower dose, 25 mg for women and 50 mg for men, and increasing by 25 mg after six weeks, if needed. Exceed this dose only if you’re working with a doctor. To make sure your DHEA level stays in the range of a young adult, have your blood tested periodically while adjusting your dose.
  • If you’d like to learn more about the Whitaker Wellness Institute’s safe, natural approaches to treating depression, contact a Patient Services Representative at (866) 944-8253 or click here.

References

  • Szegedi A et al. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St. John’s wort): randomized controlled double blind non-inferiority trial versus paroxetine. BMJ. 2005 Mar 5;330(7490).
  • Southern California Evidence-Based Practice Center. S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease (Evidence Report/Technology Assessment No. 64). http://www.ahrq.gov/clinic/evrptfiles.htm#same
  • Kravitz RL et al. Influence of patients’ requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA. 2005 Apr 27;293:1995-2002.
  • Schmidt, PJ et al. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry. 2005 Feb;62(2):154-62.

Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2005. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healingclick here.

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