Herbal Adjuncts to Antidepressants

Abstract

The intentional use of herbal medicines to increase efficacy or decrease adverse effects of antidepressant drugs is reviewed, with notes about situations (mostly isolated case studies) in which such combinations might have been harmful. Hypericum perforatum (St. John's wort), a common antidepressant herb, is reviewed first, given that there are a number of concerns about possible harms that might arise from its use with various antidepressants. Although a handful of case studies suggest that there are problems, there is little definitive information, and preclinical research suggests the possibility of benefits.The safety of combining various herbs with monoamine oxidase-inhibiting drugs is reviewed next. Studies supporting the use of Crocus sativus (saffron) and Ginkgo biloba (ginkgo) to offset sexual adverse effects of selective serotonin reuptake inhibitors (SSRIs) are reviewed. Pausinystalia yohimbe (yohimbe) and its alkaloid yohimbine's ability to augment antidepressant therapy is discussed. The use of the herbal formula Rikkunshi-tō (Liù Jūn Zǐ Wán) to offset gastrointestinal adverse effects of SSRIs is reviewed. Finally, research on combining Rauvolfia serpentina (Indian snakeroot) and its alkaloid reserpine with antidepressants is mentioned. Much more research is needed in this area, given how frequently antidepressant drugs and herbs are used by patients.