Sarah was referred to me by a local psychiatrist after she had been treated for a year with Wellbutrin, Restoril, Ativan, and Depakote with minimal success. She was also diagnosed with Hashimoto's Thyroiditis. She was twenty years old, obese, non-working, and felt overwhelmed by life in general. She also endured digestive problems, low back pain, and frequent frontal headaches.
I spoke with her psychiatrist about the herbal alternatives: she wanted to try another path. Her life path wasn't being facilitated and strengthened, and she knew something crucial was being ignored; a piece of the puzzle was missing. Her goals were inclusive of being a functioning member of society, working, laughing, getting back to the physique she had only a couple of years before; it was time to try another path, possibly a substance which covers a more global effect on the body.
St. Johns Wort Extract appears to clearly augment several pathways of depression in the brain which we have not yet discovered, along with the ones we do understand. We agreed that the best way to lower the prescriptions was to create a "window" through which we can see the effects of an herbal substitute for the depression by dropping the dose of one of the antidepressants or antianxiety drugs and waiting to have a clearer glimpse of the underlying symptoms; it is now the subject of many herb and drug companies that the herbal antidepressants have literally taken over the Prozac marketplace in Germany. That means something significant, for both the way we think of depression in our times and for its psychopharmacologic activity.
Lets examine St. John's Wort in light of the neurological mechanisms through which it works, and then tell you about the products that are out there and which ones really work.
It is well understood that combinations of herbs usually work better than single herbs alone. The dynamics of taking several substances which act in similar ways make it less possible for the body to habituate or develop a tolerance for any single product, and therefore any potential toxicity, side effect or tolerance potential is minimized.
Earlier in drug company history the antidepressants were both Serotonin Reuptake Inhibitory (SSRI) and Norepinephrine reuptake inhibitory (NRI). The NRI portion caused side effects such as drowsiness, blurred vision, dry mouth, laxative. Then they invented drugs such as Prozac which had eliminated the NRI portion. The pharmacologists thought that it wouldn't work as well, but it in fact worked better.
With Hypericum, there are only remnants of effects such as dry mouth and light hypersensitivity (do not expose yourself to extended sunlight when you take Hypericum, or early burning will occur), and Hypericum when mixed with other herbs such as Kava Kava and Zinc salts will be absolutely minimized of any side-effect due to its NRI activity, and in fact Hypericum has so many more benefits to the wellness of the natural cycles found within the nervous system and immune systems as well, it is senseless to exclude Hypericum from the top lists of antidepressant options.
St. John's Wort or Hypericum perforatum extract is best made from the buds of the plant. According to mostly German pharmacological research, Hypericum has the following roles:
1) Has a Serotonin reuptake inhibiting action (SSRI) like Prozac and other popular antidepressants (1)
2) Inhibits Norepinephrine uptake (2)
3) Inhibits the stress-induced CRH, ACTH and cortisol secretion in the adrenals by inhibiting cytokines excreted by white blood cells (3) which serves as a buffering to the onset of stress above accommodation levels. Therefore since these hormones CRH and ACTH actually inhibit the immune system, Hypericum does not allow this to occur, and stress no longer affects the immune system.
4) Substantial evidence of MAO inhibition. MAO is an enzyme which breaks down neurotransmitters serotonin and norepinephrine; if you inhibit the breakdown then you supply more serotonin and norepinephrine, therefore acting against depression.
S) Increases light-induced suppression of melatonin and increases the nocturnal melatonin blood concentrations. Therefore the regulation of the sleep-waking cycle is enhanced and the autonomic nervous system becomes more balanced. Regulation of the active and passive actions of the nervous system are indications of true health, as seen through the work of Selye et. al. This is also similar to the ways pharmaceutical antidepressants Amitryptiline and Desipamin operate (5). Why take a drug when you can take a plant?
6) Increases neurotransmitter metabolites in the urine, signifying that there are greater supplies of neurotransmitters being produced in the brain(4)
7) Inhibits the enzyme dopamine-B-hydroxylase in vitro (6). Dopamine B hydroxylase breaks down the neurotransmitter dopamine, which is involved in the pathophysiology of schizophrenic psychosis and Parkinson's disease. Warning: this increase in dopamine may increase prolactininhibitory factor, which diminishes the secretion of prolactin, this means that nursing mothers should avoid hypericum, but at the weaning time they may want to start it. It will also help them through the depression of lactation withdrawal ! (7)
8) Hypericum has been shown to increase the binding to benzodiazepine receptors. This means that Hypericum has a marked effect on anxiety, and acts as a mild diazepine (similar to Valium) (8)
9) Hypericum increases theta activity during sleep. This means an increased ability to visualize, to calmly dream, with increased perception and clarity of mind. Perfect for cancer patients, since they are frequently helped with visualization, and when going through chemotherapy they frequently need White blood cell fortification, which Hypericum creates.
There may be a period of up to 3 weeks that the St. John's Wort (Hypericum perf.) comes to a stable neurochemical level, and there may be some period of adjustment involved. I double the dosage for the first five days, and add synergistic herbs and a specialized Zinc salt for maximizing Blood Brain Barrier perfusion-uptake.
Several Hypericum products have come out on the health food market. The first one I tested amongst 50 patients was Phytoproz by Gaia Herbs. Another 30 took Zand's Calming formula. Once or twice a year I visit one of several colleagues of mine in Germany. While I did some clinical practice there alongside a couple of well-known oncologists, I took a look at their combination remedies for depression. They often used a dilution of a mineral made from the combination of Zinc and Valerian, called Zinc Valerate. I tried this over here, since it is made in homeopathic form, down to a 3x potency. I found it worked as a "catalyzer" in a way, - a facilitator and also a deeper psychological regulator of emotional imbalances. I went looking for a company which made a similar product. Nutricology did such a thing. I searched the literature for the effects of this salt. It bore a long history of being used in anxiety disorders, and had several citations for its apparent antifungal properties, as well as specifically being used in the inhibition of certain degenerative processes.
Allergy Research/Nutricology has constructed such a supplement, called ProzaPlex. It contains Hypericum, Kava Kava, Schizandra, a special orchid extract which has neurological effects, and a few other herbs which not only lift the emotional state but are natural aphrodisiacs. I found ProzaPlex to be the best, also because it is in capsule/pill form, and this makes it relatively painless to take (many of the herbal antidepressant complexes are in alcohol tincture base and taste terrible). I have 55 patients who have taken this complex and have lessened their anxiety/depression index by 40-90 percent within 3 weeks.
Hypericum extracts are rapidly replacing drug antidepressants in Europe. In the last 4 years the majority of depression patients are on Hypericum and no longer on antidepressant drugs. The doctors are becoming wise: they are using Hypericum as their first-line prescription strategies for mild to moderate depression (80% of the cases), anxiety, insomnia, chronic viral Iymphadenitis associated with depression and instability, and panic disorders.
Needless to say, my patient is off all her drug meds except a quarter-dose Depakote. She has a full-time job, the thyroiditis is gone, she sleeps every night. Thanks to the state-of-the art herbal/mineral ProzaPlex by Allergy Research Group.
ProzaPlex consists of:
Other ingredients for energic regulation of the neurovegetative system:
In my practice I have used this combination on roughly 55 patients with excellent results 7/8 of the patients benefit significantly. I choose to prescribe in the the following cases:
2-3 capsules twice a day. Maximum dose: 3 capsules three times a day. Neurochemical levels are maximized in 20 days. Co-administration of nutrients and lipotropic as well as gut permeability factors are advised frequently.
Do not use in pregnancy or lactation unless under the care of a physician.
Half dose for children 8 and older. Not intended for use in children under 8. Avoid moderate to heavy sunlight exposure while taking any St. John's Wort product .
Keep away from children.
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