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Awaiting moderation 17501 Article |
St john's wort in the breakfast vitamins: a single-blind study ST JOHN'S WORT IN THE BREAKFAST VITAMINS: A SINGLE-BLIND STUDY
Louise, a professional woman who has been in treatment with me for several years, has in the course of this time become knowledgeable about the administration and regulation of antidepressant medications and, as a consequence, is much sought after for her opinions in this regard even though she has no formal medical training. Accordingly she was consulted by her friend Sylvia, in connection with Sylvia's husband's difficulties. Sylvia believed that Sam, her husband, was suffering from depression because he seemed 'down in the dumps, sits in front of the television till late at night and self-medicates with junk food - anything he can eat without cooking it; anything that comes in a box, such as our baby's rusks'. In addition, he was having a hard time getting to sleep at night, was staying up till the early hours of the morning and was isolating himself. Sylvia was worried because Sam had previously been a very optimistic person, believing the world essentially to be a good place, full of opportunities, before a series of business reversals had set off these changes in him. She knew that several members on both sides of his family had suffered from depression. When he barricaded himself in the bedroom one night, a highly unusual thing for him to do, Sylvia had reached her limit. It was time to consult Louise. The idea of suggesting that Sam go to a psychiatrist was completely impractical. 'He doesn't think there is anything wrong with him,' Sylvia explained to me. He would never have gone and wouldn't have considered taking Prozac or any anti-depressant. How might she handle such a refractory patient, she asked Louise in one of their regular phone calls. Louise suggested that Sam try St John's Wort.
The idea was immediately appealing to Sylvia, but certain logistical problems presented themselves. First, she was unable to get her hands on St John's Wort in the small town where they lived, and second she knew Sam to be highly suggestible and she wanted to be sure that he was really better and that she was not dealing with some half-baked placebo effect instead. Louise told her that the first problem could be easily solved, as she herself would send Sylvia the right type of St John's Wort. As to the placebo effect, Louise enquired about Sam's daily activities, and on discovering that he was in the habit of taking vitamins every morning with breakfast, suggested that Sylvia simply inform Sam that the St John's Wort tablets were additional vitamins and add them to the mix. Sylvia approved of the plan. She knew that Sam was generally distracted by work-related matters at breakfast time and, not being by nature a suspicious person, would readily take whatever tablets Sylvia gave him. 'He's lucky I like him,' she observed, adding 'I'm a suspicious person; you could never get away with giving me extra pills.' Nevertheless, she could not push her luck too far and ask him to take vitamins in the evening, which would have constituted a major change in his daily activities and would have elicited suspicion even in a highly trusting husband. In addition, as she noted, T have no control over his lunch.' So even though St John's Wort is supposed to be administered three times a day, Sylvia decided he would have to take all three tablets at breakfast. She knew that the herbal remedy was best taken with food and reckoned that 'if he gets sick, it will be immediate and I will know what caused it.' She was pleased to see that he tolerated the new pills just fine.
After about five to six weeks, Sylvia noticed a remarkable improvement in Sam's mood and demeanour, which she characterized as 'happy but not manic'. He became 'more balanced, grounded, present and alive, better than he has been in years'. He stopped watching as much television, picked up his old musical interests again and spent more time with the baby. In addition, he became 'like a sex machine, morning and night, he was ever-ready' Every time Sylvia walked into the room 'there was a look in his eye'. She had not seen anything like it in him since they were first married 10 years before.
In fact, Sam was feeling so good that he told Sylvia that he no longer needed the new vitamins. At that point she felt constrained to explain to him why he was feeling so good and why he had better not stop the new vitamins. He took the news like a good sport, and acknowledged that he felt a new lease of positive energy in him. Now he says that he feels so good that he will happily take St John's Wort for the rest of his life, if that's what it takes to stay happy.
*5\75\2*
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