A greater percentage of individuals with mental
illness use alternative medicine than the general
population.19 Simon et al reported that approximately
10 percent of visits to a complementary/
alternative medicine (CAM) practitioner were for a
mental health-related complaint.20 A large survey
by Druss et al indicated that self-reported mental
conditions were associated with increased use of
CAM treatments.21 Despite its well-recognized
morbidity, mortality, and associated disease
burden, MDD is frequently treated with unproven
alternative medicines.22 In a primary care study,
the use of herbal products was specifically associated
with a depression diagnosis.23 Although
consumers are self-medicating for mild depressive
symptoms, those with severe depression or anxiety
reportedly use alternative treatments the most
often, with 41 percent of severely depressed
patients using at least one nonconventional
treatment for depression, compared to general
CAM use in 28 percent of the overall adult population.17
According to another U.S. survey, approximately
nine percent of those with severe depression
specifically used alternative pharmacotherapy
as a treatment approach.22 Similarly, in a study
conducted in German pharmacies, patients who
purchased SJW reported pronounced and persistent
depressive symptoms.24 Benefit in pediatric
patients is also implied.25 !e topic clearly remains
an area of interest, as new review articles and
meta-analyses describing SJW and/or SAM-e as
potential first-line alternatives to conventional
antidepressants continue to appear in the literature.26-32
In addition, there is a multitude of
internet websites touting the benefits of both
products.