What a Major Slapdown Means for a Little Pick-Me-Up

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You're still popping Mother Nature's little helper — and you're still depressed.

That's no surprise, according to a study published in this week's Journal of the American Medical Association. According to the report, St. John's Wort, long hailed as the "natural Prozac," doesn't do a whole lot for people with moderate to serious depression.

The study, sponsored by Pfizer (maker of both the antidepressant heavyweight Zoloft and herbal supplements) and the National Institutes of Mental Health, included 200 patents who took either St. John's Wort or a placebo pill for eight weeks each. The patients who took the herb showed very little or no improvement in their depression — the same results as the patients taking the placebo.

Paul Doering, distinguished service professor of pharmacy practice at the University of Florida in Gainesville, spoke with TIME.com Wednesday about the study and the future of St. John's Wort.

TIME.com: Were these results surprising to you?

Doering: Not at all. But then, I was very aware of this study. In fact, a year ago we happened to visit one of the sites where the study was actually going on and interviewed one of the test administrators as well as a patient involved in the study. That patient, interestingly enough, had great results — but she was on the placebo.

I wasn't really surprised by the overall results of the study. We pharmacists are the doubting Thomases of the drug industry because we've been taught that if you can't prove a result in a super-strict double-blind crossover study, it's not a real result. I am trying to become a bit more open-minded, but there are some things that just have to be proven scientifically. And the efficacy of anti-depressants, which are used, after all, to treat a serious illness, is one of those things.

The results of this study run totally counter to what we've heard out of Europe concerning St. John's Wort. Is there an easy explanation for that discrepancy?

Defenders of herbal medicine will argue that this study involved test subjects with moderate to severe depression, where most of the European studies involved mild depression, and that St. John's Wort was never marketed as a solution to those grades of depression.

So does St. John's Wort get to maintain its claims of combating very minor or mild depression?

It might conceivably help some people who feel out of sorts — but I would not recommend it for anyone who had what could technically be termed "depression."

So is this the end of the road for St. John's Wort? Will it fall completely from grace due to this study?

It's too soon to tell just yet. There's another study going on right now comparing St. John's Wort with Zoloft, and those results aren't out yet. But I do think overall that the public mood regarding herbal supplements is coming back to center. We're seeing a new era of caution; over the past couple of years we've seen that these "all natural" supplements can interact with traditional drugs and have very real side effects. So at this point, a little caution is definitely a good thing.

So are we seeing the beginning of the end of the herbal era?

Not necessarily. The key for consumers is figuring out where herbal or alternative treatments fit into the traditional scale. Are they meant to replace traditional medicines? In the case of serious or potentially serious illness, probably not.

If someone comes and asks me personally, "Oh, should I take this, I've heard so much about it in the press, should I take that?" I try to draw as much of their history as possible out of them and then find out what they want from this drug or supplement.

If someone comes to me and says, "I can't go on, can't face another day, I've lost all hope," I'm obviously looking at someone with a pretty severe depression. And so I'm not going to say, "Here's some herbs, oh, and by the way they'll take about six weeks to kick in."

Does St. John's Wort still have any place in the treatment of mood disorders?

I think for people who are feeling a bit down in the dumps it might be a good alternative to some of the heavy-duty psychotropic medications that are out there. But for more severe or even moderate depression, I think we're finding that St. John's Wort is probably not the answer.