Many people are curious about alternative treatments for depression, either because they hope to avoid drug-related side effects or because they are reluctant to see a doctor for their depression. Such self-treatment can put people at risk, however.

For one thing, a person who self-medicates may not realize the depth of his or her depression or recognize worsening symptoms. For another, herbal and other alternative remedies are not benign and have potential side effects of their own, including the risk of drug-herb interactions.

St. John's wort, an extract from a yellow flowering plant called Hypericum perforatum, is the best known of "natural antidepressants." The American College of Physicians and the American Society of Internal Medicine have included it in their guidelines as a short-term treatment option for mild depression, but a recently published overview of research on the herb notes that studies conducted to date have produced "inconsistent and confusing" results.

Thus, until there is clear evidence that the supplement is effective, people with major depression should avoid using St. John's wort, and those with mild-to-moderate depression should use caution and be sure to consult their doctors before using it. In addition, anyone who uses St. John's wort needs to be aware of potential side effects.

Research shows that St. John's wort interferes with a range of medications, including those prescribed to treat depression, heart disease, seizures and some cancers. The supplement may also cause increased sensitivity to the sun.

Another supplement widely touted for treating depression is S-adenosylmethionine (also called SAM-e, pronounced "sammy"). But results of the published studies that purport to show the benefits of SAM-e are not at all convincing, and there are troubling hints that it may trigger mania in susceptible people.

Researchers have studied melatonin for SAD, but there is limited information on the optimal dose and timing. In addition, melatonin is a hormone and thus should be taken only with your doctor's knowledge.

Publication Review By: Karen L. Swartz, M.D.

Published: 19 Jun 2013

Last Modified: 19 Jun 2013