Nature's Mood Boosters

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Five natural supplements
to combat stress, anxiety
and depression.

MOTHER raised the subject recently with Dr. Richard Firshein, an expert in nutritional research and medicine. He agreed to give us the lowdown on five of the more talked about natural mood boosters: St. John's wort, ginkgo, kava, tyrosine and SAM-e.

Marguerite Lamb for MEN:St. John's wort was among the first herbal supplements to break into the mainstream market, and it remains the leading natural antidepressant. But do we know yetif and how it works?

RF: We are still not sure of how St John's wort works. Several mechanisms have been proposed. The most likely is that it works as a selective serotonin reuptake inhibitor [SSRI], similar to Prozac. But originally it was thought to work as a monoamine oxidase inhibitor [MAOI]. [For more on SSRIs and MAOIs, see box at left.] It was also thought that the active ingredient in St. John's wort was hypericin, but some more recent research indicates that there may be a whole slew of compounds at work.

MEN: So how this herb works is still very much under investigation, but do we know that it works?

RF: Well, I think there is some good research going on. There have been some excellent [foreign] studies done over the last several years showing that it does improve mild to moderate depression. And there is a study that is currently being done in the U.S., which should be out within the year.

MEN: You mean the $4 million National Institutes ofHealth-sponsored study? Is this our government's first serious look at a natural antidepressant?

RF: It's been a long time in coming, but this is our first real look into whether or not there are natural approaches to treating depression.

MEN:Are there any precautions associated with using St. John's wort?

RF: I would be careful about using it with other antidepressants. Anytime a patient is thinking of using St. John's wort, it is a good idea to talk it over with his or her physician, particularly if someone is taking another medication and either wants to switch to or add St. John's wort. That should be discussed very carefully. Some other concerns are that St. John's wort may cause sun sensitivity, and it may interfere with anesthetics. If patients are taking antidepressants, and particularly MAO inhibitors, we generally ask them to stop before surgery.

MEN:Let's move onto ginkgo, which has been shown in studies to relieve mild to moderate depression. Is this related to ginkgo's widely reported ability to improve blood flow to the brain?

RF: There are probably several mechanisms at work. One is the increased blood flow. Ginkgo works as a platelet activating factor inhibitor and what that means is that it thins the blood. But at the same time it also increases the amount of oxygen that can be transported [in the blood]. It also works as an antioxidant ...and that is very important to brain chemistry as well.