Medicating Depression

[rats]

Just read this:
http://www.guardian.co.uk/medicine/story/0,,1755741,00.html

Is it just me, or has the author gone for tabloid-like revelations?
For example:

Separately the mental health charity Depression Alliance has written to the National Institute of Health and Clinical Excellence, which approves medicines for use by the NHS, appealing to it to consider how complementary therapies are used to treat depression because, it says, there is an overwhelming demand from patients.

… is swiftly followed by:

Research for the charity found 11% of members of the public questioned had either tried a complementary therapy to deal with depression or had a friend of family member who had.

Is 11 % overwhelming?

What did make me laugh:

Lynsey Conway, a trustee of the alliance, said: "We get so many hundreds of calls about complementary therapies and it seems there is a complete lack of guidance, support of medical evidence."

Such articles do wind me up...
How large was the sample survey size?
Ah, from the charity’s full report, 1000 people were surveyed. Now, I’ve no experience with the type of experiments that require surveys, but surely an indication of who the surveyed people were would be interesting: age, income, location?
Also, I know the survey was conducted in the UK, but couldn’t many of the people drinking alcohol everyday simply be drinking a glass of wine with a meal?
Shouldn’t there have been a link to original report, or press release?

A quick search on St. John’s Wort led me to this:
http://www.bbc.co.uk/health/ask_the_doctor/stjohnswort.shtml

For a start, I hadn’t realised articles could be ‘medically’ reviewed. Secondly, where are your references, Dr Trisha Macnair? I may write an email to the BBC… Could anyone back me up with references (yes, plural!) indicating the efficacy of St. John’s Wort on depression (or lack of)?

Thanks for proving space for my rant. I feel better, and apologise if some of my points weren’t too cogent

 

[ChristineR]

Here's a link for St. John's Wort:

http://nccam.nih.gov/health/stjohnswort/

Cites for the most important studies are at the bottom of the page. Here's my summary of St. John's Wort:

A few small studies showed that St. John's Wort is effective for mild depression. The larger and well controlled studies did not find it useful. However, no one is sure what the active substances in St. John's Wort are. Generally it's believed that the active ingredient is a drug called hypercium. Most of what is labeled St. John's Wort in the U.S. is actually hypercium extraced from St. John's Wort. Hypercium is a prescription drug in Europe. (I believe this is true--not sure about all the countries.)

Some people believe that St. John's Wort may contain more than one active drug, and that best effects are obtained with hypercium that accidently contains some of these other drugs.

In the U.S. at least hypercium is widely used as a cheap self-help remedy by people who don't have proper health insurance. Hardly ideal, but I'm not sure if life would be better if it were banned. (It was banned until the 1980s).

MacNair is...no polite words. That article is...no polite words.

 

[Mongrel]

Generally it's believed that the active ingredient is a drug called hypercium. Most of what is labeled St. John's Wort in the U.S. is actually hypercium extraced from St. John's Wort. Hypercium is a prescription drug in Europe. (I believe this is true--not sure about all the countries.)

Martindales has two preparations in European Pharmacopeia (5th Edition) for Hypercim.
St Johns Wort - containing not less than 0.08% hypericins
and
Hypericum for Homeopathic Preparations - The whole fresh plant at the beginnning of the flowering period.

No prescribable items were listed for the UK.

 

[Melendwyr]

Of course there's no medical evidence for "complementary" treatments. They're not utilized in medicine usually because they have no clinical benefit. As long as they don't cause harm, medical professionals ignore them.

 

[luchog]

From what I recall, talking to my doctor, is that St. John's Wort is effectively an SRI; but is not recommended because of the high variability in the presence of active components, and lack of quality control common to herbal supplements.