Alternative medicines such as herbal remedies have been growing in popularity in both Europe and North America. Many people with anxiety disorders such as OCD have tried alternative therapies at one time or another. One of the most popular herbal remedies for anxiety is St. John’s Wort.
Why Use St. John’s Wort to Treat OCD?
Although the effectiveness of St. John’s Wort in treating depression and other forms of mental illness is still a matter of some controversy, St. John’s Wort has been widely used (and in some cases, licensed) in Europe for decades to treat mood and anxiety disorders. In addition, in animal studies, hypericum, the chemical thought to be the key ingredient in St. John’s Wort, appears to affect the serotonin system. Disruptions in the serotonin system are thought to be important in the development of symptoms of OCD.
Given that antidepressant medications such as Paxil (Paroxetine) and Anafranil (Clomipramine) that target the serotonin system are also effective in treating OCD, it has been suggested that St. John’s Wort could be an alternative therapy for reducing OCD symptoms.
Is St. John’s Wort an Effective Treatment for OCD?
The evidence that St. John’s Wort is an effective treatment for OCD is limited. A case study using only one patient suggested that St. John’s Wort was effective in reducing symptoms (Rosenblatt, 1997). A second, larger study using 12 people with OCD found that St. John’s Wort produced a significant reduction in symptoms that was similar to what would be expected with treatment with a selective serotonin reuptake inhibitors or SSRIs (Taylor and Koback, 2000).
Neither study, however, properly accounted for the placebo effect. In both cases, the people participating in the research studies were told up front they were going to be receiving St. John’s Wort in hopes of reducing their OCD symptoms. Simply knowing they were receiving a potentially beneficial treatment could have been enough to cause people to feel better.
Studies evaluating the effectiveness of medications should include placebo treatment group that receives a “sugar pill” that is inactive and could not possibly account for any reduction in symptoms or side-effects. By using a placebo treatment, it is possible to tell if the actual drug had an effect or not. It is also important that neither the researchers nor the study participants know who is receiving what treatment until the study is over – this could also bias the results.
To date, there has only been one placebo-controlled study which has looked at whether St. John’s Wort is effective in reducing OCD symptoms. In this study (Kobak et al., 2005), 60 people randomly received either St. John’s Wort or a placebo. At the end of the study, the reduction in OCD symptoms among those who took St. John’s Wort was no different than those who received the placebo.
Is an Herbal Remedy Right for Me?
Currently, there is limited evidence that herbals like St. John’s Wort are beneficial in reducing the severity of OCD symptoms; however, more research is needed in this area.
Most herbal remedies are available at your local drugstore without a prescription. Indeed, most people take herbal remedies like St. John’s Wort without consulting a medical doctor or expert in alternative therapies such as a naturopathic physician.
Although many consumers believe that herbals are safer and/or have less side effects than prescription medications, herbals, like St. John’s Wort, are not regulated as closely as conventional medications and may cause unpleasant or even dangerous side-effects in some people. For example, Kava, a herbal used to reduce anxiety has been banned or restricted in some countries after suggestions that it may cause liver problems in some individuals.
Herbals can also interfere with prescription medications you may already be taking. For example, if you are currently taking an SSRI to treat OCD, it essential that you consult with your doctor before taking St. John’s Wort as it could affect your body’s ability to metabolize these and other types of medication. It could lead to a problem known as serotonin syndrome.
If you are thinking about taking a herbal or other alternative therapy to help with symptoms of OCD, be sure to consult with your doctor or a registered expert in alternative therapies such as a naturopathic physician.
Sources:
Kobak, K.A., Taylor, L.V., Bystritsky, A., Kohlenberg, C.J., Greist, J.H., Tucker, P., Warner, G., Futterer, R., & Vapnik, T. “St. John’s wort versus placebo in obsessive-compulsive disorder: Results from a double-blind study.” International Clinical Psychopharmacology 2005 20: 299-304.
Rosenblatt, J.E. “Currents“ Current Affective Illness 1997 7: 472-483.
Taylor, L.H. & Kobak, K.A. “An open-label trial of St. John’s Wort (Hypericum perforatum) in obsessive-compulsive disorder” Journal of Clinical Psychiatry 2000 61: 575-578.
