A large class of natural herbal treatments with very definite psychoactive properties are widely recognized in Europe as viable alternatives to antidepressant drugs such as Prozac, Wellbutrin, Zoloft, and Paxil. "The herbal antidepressants have literally taken over the Prozac marketplace in Germany," writes Dr. Daniel Beilin, an herbalist and acupuncturist in Aptos, California.

ProzaPlex, a new herbal treatment that is giving Prozac a run for its money, is based on an herb called St. John's Wort, which also goes by the more technical name Hypericum peforatum.

Among several modes of action, Hypericum is recognized for its ability to:

1. Inhibit serotonin reuptake, resulting in higher serotonin levels. Serotonin is a neurotransmitter, a vehicle of communication between nerve cells. This effect is similar to that of Prozac and other popular antidepressants.
2. Inhibit uptake of norepinephrine, the brain and nervous system adrenaline. Like serotonin, more norepinephrine seems to act against depression.
3. Inhibit certain stress-related responses, such as the secretion of cortisol and other hormones beyond the necessary accommodation levels. These hormones can inhibit the immune system, so this action helps maintain fully effective immune responses under stress.
4. Inhibit an enzyme that breaks down serotonin and norepinephrine, helping to maintain higher levels of these substances.
5. Increase both the light-induced suppression of melatonin and nighttime melatonin levels, which act against seasonal affective disorder and related depression by helping to regulate day/night and sleep/wake cycles. The drugs Amitryptiline and Desipamin work the same way but have unfavorable side effects.
6. Increase production of neurotransmitters in addition to serotonin - improving nerve cell communication.
7. Promote production of an enzyme that breaks down the neurotransmitter dopamine, resulting in higher dopamine levels. Dopamine levels affect adrenaline and offer "feel-good" benefits.
8. Increase the binding power of benzodiazepine receptors, an action similar to that of Valium.
9. Improve ability to dream during sleep. The reasons for dreaming are still unclear, but it is presumed that effective dreaming might be an important part of stress management.

This is powerful stuff, not to be used as indiscriminately as, say, vitamin C or garlic supplements. But the multiplicity of modes of action sheds light onto the real differences between drug and herbal treatment: The drug manufacturer attempts to isolate a single action and to refine and purify a single chemical product that will affect that action and do a minimum of other things. Prozac is a good example. Earlier antidepressants inhibited the reduction of both serotonin and norepinephrine. But the second mode of action caused side effects like drowsiness, dry mouth, and blurred vision. So that part was eliminated, and Prozac probably works through one mechanism alone.

The Hypericum-based herbal treatment, on the other hand, spreads the effect over a much greater number of elements in the total neurological and hormonal picture, making it far less likely that any one resulting action will produce unintended and undesirable side effects. Herbal treatment formulations in general take this one step further by combining many herbs that have overlapping modes of action. That way, the probability of developing a tolerance for one substance, leading to diminishing results, is greatly reduced.

Numerous studies confirm its effectiveness

One double-blind, placebo-controlled study, representative of several published in Germany, found a 70 percent response rate among 97 outpatients who received 100 to 120 mg of Hypericum extract. "Treatment resulted in an appreciable improvement in the symptoms of depression, and the 70 percent response rate corresponded to that of chemical antidepressants. The substances were extremely well tolerated, and no side effects were reported by any of the patients. (Fortschritte der Medizin, vol. 113, no. 28, pp. 408)

And from another article in Fortschritte der Medizin (vol. 113, no. 25, pp. 354-5): "Recent studies have shown that it [St. John's Wort] is clinically effective for the treatment of the symptoms of depression. It has proved superior to placebos and equally as beneficial as standard medication, over which it has a clear advantage in terms of side effects. It follows that, on the basis of our present knowledge, St. John's wort can be recommended for use as an antidepressant."

A good thing made even better

New St. John's Wort Formula Adds Important Botanicals

• Kava Kava is a Polynesian drink with psychoactive properties, used extensively for medicinal purposes in some traditional island cultures. It appears to be nonaddictive with few known side effects and may act like tricyclic drugs, although the mechanism is not known.
• Schizandra is believed to protect the liver against oxidative damage and improve its capacity to safeguard against foreign enzymes introduced by treatment.
• Zinc salts help control the permeability of the "blood-brain barrier" and are believed to improve the effectiveness of Hypericum.
• Orchid root is another psychoactive herb found to be useful in rehabilitation - from addiction to other stimulant drugs.

The nature of depression and the far-reaching effects of many of the treatment options argue against self-treatment, even with a relatively safe herbal remedy. However, not everyone has access to a practitioner who is sympathetic to the alternatives to drugs, especially outside of Europe. So a few warnings are in order for the experimenters. Because of Hypericum's suppression of response to light, there is increased danger of serious sunburn while using it. Keep this in mind especially if you are using any photosensitizing drugs. Also, the mechanism that increases dopamine levels inhibits prolactin, so nursing mothers should avoid Hypericum.

In addition, tyramine-containing foods (red wine, aged cheese, chicken liver, soy sauce, sauerkraut and most especially dairy products, should not be taken with Hypericum unless blood pressure is monitored.

Each capsule of ProzaPlex provides:

St. John's Wort (0.3% hypericin)

Kava Kava 4x Valerian 4x Passiflora 4x Schizandra 4x Gotu Kola 4x Cypripedium Zinc Salts

120 mg 60 mg 30 mg 30 mg 30 mg 15 mg 2.5 mg 2.5 mg

Suggested Use: As a dietary supplement, one (1) capsule, one to three times daily with meals, or as directed by your health practitioner.