Online Program

St. john's wort for depression, omega-3 fatty acids for mood stabilization and depression, and cranial electrical stimulation for substance use rehabilitation, depression, anxiety, and sleep disorders

Wednesday, November 6, 2013 : 8:50 a.m. - 9:10 a.m.

David Mischoulon, M.D., Ph.D., Depression Clinical & Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
David Shern, Ph.D, Johns Hopkins University, Tampa, FL
St. John's wort is the most popular CAM product used for mental health conditions in America. All sources agree that it is effective for mild to moderate depression. Two sources found St. John's wort effective for more severe depression as well. Based on their clinical practice, Brown et al found St. John's wort effective for treatment of anxiety disorders, chronic fatigue syndrome, fibromyalgia, menopause, schizophrenia and seasonal affective disorder. The major drawbacks of St. John's wort are the risk of triggering “cycling” in people with bipolar illness and the danger of interaction with many drugs. It is dangerous to mix St. John's wort with antiretroviral medications and with psychotropic drugs. Omega-3 essential fatty acids are essential for brain and heart health. Four sources found them effective in treating mental health conditions. While they have been most studied for use in depression and bipolar disorder, the sources urge that they are a promising treatment for postpartum depression, schizophrenia, borderline personality disorder and cognitive impairment/dementia. Drug interactions and side effects are minimal. Cranial Electrotherapy Stimulation (“CES”) uses a current that cannot be sensed by the consumer. Brown and Gerbarg is the only source that discusses CES, although Mischoulon is currently studying it. Two early studies of CES found increased attention and concentration in normal adults. Brown and Gerbarg add that in clinical practice, they have found that CES can improve attention, reduce anxiety, and relieve insomnia, all helpful in treating ADHD. No drug interactions or side effects have been reported.

Learning Areas:

Advocacy for health and health education
Basic medical science applied in public health
Chronic disease management and prevention
Clinical medicine applied in public health

Learning Objectives:
Describe use and evidence of comparative effectiveness of St. John’s wort. List two CAM therapies that have been found helpful in treating depression.

Keyword(s): Mental Health Care, Herbal Medicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Board certified by the American Board of Psychiatry and Neurology, Director of Research and Alternative Remedy Studies for the Depression Clinical and Research Program at Massachusetts General Hospital (MGH), and Associate Professor of Psychiatry at Harvard Medical School, I have authored or co-authored more than 100 original articles, review articles, and book chapters, and have co-edited a textbook on CAM treatments for psychiatric disorders, Natural Medications for Psychiatric Disorders: Considering the Alternatives (2002/2008).
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
FisherWallace Cranial Electrical Stim Research support
Ganeden Probiotics Research support
Nordic Naturals Omega-3 Research support
Methylation Sciences SAMe Research support
Lippincott Williams and Wilkins Publishing Book royalties

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.