Can't find the papers I have on St.John's wort, and my Pubmed access does not work at home.
Here are a few other interesting bits I have though:
DEPRESSION: A DISEASE OF ENERGY PRODUCTION
By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr
The incidence of depression in Australia has often be underrated. According to a report by the Australian Bureau of Statistics of 21 April 2004, over 18% - that is one in nearly five adults - of all Australian adults had experienced a mental disorder during the preceding year.
The prevalence of mental disorder was similar for men and women, but there were differences in the types of disorder suffered: 12% of women and 7% of men had anxiety disorders, while 7% of women and 4% of men had affective disorders (which include depression). Some 11% of men and 4% of women had substance use disorders (such as drug or alcohol dependence).
Standard treatment for depression is usually by either antidepressant medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) and/or psychotherapy.
A study in January 2006 by TR Insel showed that only about 40% of patients have some benefits from AD medication as per quote here:
“For each of these interventions, one can say with some confidence that at least 40% of a cohort with depression will show statistically significant reductions in unbiased ratings of depression. This information, while entirely commendable in the world of research, is far from satisfactory in the world of practice where an individual clinician needs to make treatment decisions to help an individual patient.”
Of course, it should be realized that drugs - even though they benefit some patients - do not address the the biological causes of depression which may leave them taking drugs on a long term basis..
This would leave about 60% of depressed with ‘treatment resistant’ depression. Conventional treatment would suggest that depression is ‘really’ a mental problem on the assumption that the ‘mind is at all time in control of the body’. If indeed depression is mainly due to an underlying biological disorder, meaning it is endogenous, then one could not expect that talk therapy will cure what is after all a biochemical disorder. With the inevitable side effects of drugs it does not provide an optimistic future. Thus according to the drug and/or psychotherapy model, depression is incurable. The problem appears to be that so far medicine has not come up with a treatment program that would not involve the use of drugs.
Depression is often considered complex problem, but mainstream medicine and psychology often overlook and ignore the nutritional aspects of depression. One wonders why, because it is well known that the precursors to the neurotransmitters in the brain, their enzymes and coenzymes (vitamins and minerals) all derive from the food we eat.
The alternative is to look and investigate an alternative model that relies less on the drug/psychotherapy model. The psycho-nutritional model aims to look at the causes of depression from both a nutritional and biochemical point of view.
We could start off with the idea that all biochemical machinery in our body - including brain cells - is driven along by energy. The molecule of energy is called adenosine triphosphate (ATP), that could be compared to a biological battery. An active cell in the body may use up as much as 2 million molecules of ATP per second, and hence biological energy is very important to us. When it gives up its energy it becomes adenosine diphosphate (ADP). The only way to recharge that battery is through nutrition.
The source of all energy is ultimately glucose found in food sources, that is then converted along a biochemical pathway - called glycolysis - by 10 biochemical reactions to form first pyruvate and then ATP. At each step proteins, enzymes, coenzymes, all derived form food, are necessary to complete the biochemical conversion to the next step. Thus there may be many biochemical reasons why the body has problems manufacturing its energy sources, to produce for instance serotonin - our happy hormone. And without energy we become depressed!
For example, if we have an imbalance between zinc and copper, zinc deficiency can cause a blockage in the glycolytic pathway, although blood sugar levels may appear to be normal.
Several small studies have compared 5-HTP to standard antidepressants. The best one was a 6-week study of 63 people given either 5-HTP (100 mg 3 times daily) or an antidepressant in the Prozac family (fluvoxamine, 50 mg 3 times daily). Researchers found equal benefit between the supplement and the drug. However, 5-HTP caused fewer and less severe side effects. There is evidence that 5-HTP may help prevent migraines. In a 6-month trial of 124 people, 5-HTP proved equally effective as the standard drug methysergide. The most dramatic benefits observed were reductions in the intensity and duration of migraines. Since methysergide has been proven better than placebo for migraine headaches in earlier studies, the study results provide meaningful, although not airtight, evidence that 5-HTP is also effective. >>
Similarly good results were seen in another comparative study, using a different medication and 5-HTP. Four small double-blind, placebo-controlled clinical trials examined whether 5-HTP can aid weight loss. The first, a double-blind crossover study, found that use of 5-HTP reduced caloric intake despite the fact that the 19 participants made no conscious effort to eat less. Participants given placebo consumed about 2,300 calories per day, while those taking 5-HTP ate only 1,800 calories daily. Use of 5-HTP appeared to lead to a significantly enhanced sense of satiety after eating. Over the course of 5 weeks, women taking 5-HTP effortlessly lost over 3 pounds. A follow-up study by the same research group enrolled 20 overweight women who were trying to lose weight. Participants received either 5-HTP or placebo for two consecutive 6-week periods. During the first period, there was no dietary restriction, while during the second period participants were encouraged to follow a defined diet expected to lead to weight loss. Participants receiving placebo did not lose weight during either period. However, those receiving 5-HTP lost about 2% of their initial body weight during the no-diet period and an additional 3% while on the diet. Thus, a woman with an initial weight of 170 pounds lost about 3-1/2 pounds after 6 weeks of using 5-HTP without dieting and another 5 pounds while dieting. Once again, participants taking 5-HTP experienced quicker satiety. Similar benefits were seen in a double-blind study of 14 overweight women given 5-HTP daily. Finally, a double-blind, placebo-controlled study of 20 overweight individuals with adult-onset diabetes found that use of 5-HTP without intentional dieting resulted in about a 4-1/2 pound weight loss over a 2-week period. Use of 5-HTP reduced carbohydrate intake by 75% and fat intake to a lesser extent. >>