By Jim Duke NEWS FROM THE HERBAL VILLAGE
While on my first trip to Machu Picchu in 1995, one of my travelling colleagues said that all the modern drugs had failed him in his efforts to conquer a debilitating depression. He asked the usual question, which I answered with my usual caution: "If I had depression, I'd try Hypericum before I'd resort to the synthetic option. When I got back, a friendly pharmacist, formerly with the FDA and HHS and a depression patient himself, showed me data indicating that Hypericum extracts would be efficacious for depression. The third strike came on St. John's Day, June 24, when a friend specifically requested a bouquet of Hypericum perforatum. While the happy flowers were physically attractive and psychologically antidepressant, she extracted them in herbal teas to take for her depression. Her response, anecdotally, indicated that hypericum is a very potent antidepressant.
Research has shed some light a carbohydrate cascade. The body converts starch to sugar. Sugar triggers the pancreas to release insulin. Insulin raises brain levels of tryptophan, which is a raw product in the production of serotonin. High levels of serotonin induce a feeling of well-being. Eating high carbohydrate biscuits made obese people, smoking-cessation candidates, and premenstrual women mellow. Manufacturers of Prozac maintain that serotonin controls the brain's satiety center "-sending messages that the body is hungry or full" (Prozac runs $600 to $1,400 for a years supply; WSJ,7-10-94). Scientific American (Horgan, 1996) says "psychiatrists are M.D.s and can prescribe drugs, which are cheaper than protracted talk therapy." Psychiatrists flock to breakfasts and dinners featuring lectures on the latest drugs for insomnia and depression - meals sponsored by Pfizer, SmithKline Beecham and other pharmaceutical firms. But at the 149th meeting of the American Psychiatric Association, the Eli Lilly exhibit was a "golden shrinelike tower emblazoned with Prozac" (Horgan, 1996). A lot of people are paying for that exhibit, in more ways than one. Around the Herbal Village, evening primrose, hypericum, and sunflower are free. They are even so copious as to be considered weeds by some. Together they could make an herbal combination I would try myself were I suffering depression or dysmenorrhea.
DEFINITION
Professionals define depression as a syndrome, which, on top of depressed mood, may include disturbed eating, sleeping and bowel habits, low self-esteem, the inability to derive pleasure from normally pleasurable activities, poor concentration and feelings of hopelessness. I'm depressed today as I type this, having just updated my dementia chapterlet, and contemplated the infinite sleep. Time-Life defines the even-more-serious bipolar disorder or manic depression, as a serious double-edged mental illness, with cyclical mood swings, contrasting it to the unipolar disorder, or chronic generalized depression.
EPIDEMIOLOGY
According to recent WHO data, about 3 to 5% of the world population shows clinical manifestations which can be clinically described as "depressive syndrome" (Bombardelli & Morazzoni, 1995). It's a major problem with older citizens, 4 times more prevalent among citizens over 65. It is estimated that 6 of 31 citizens in this age group suffer with depressive symptoms severe enough to warrant treatment. According to Time-Life (1996), depression in some form affects 25% of all women, 10% of all men, and 5% of all adolescents worldwide. It is the most common psychological problem in the US, affecting some 17.6 million people each year. (Time-Life, 1996).
According to Bloomfield et al. (1996), estimated losses associated with depression in the US exceed 40 billion dollars annually. "Who can put a price on the daily suffering of the 12 million Americans and 1.2 million Canadians who have depression but are not being treated?" "Untreated depression is the number-one cause of alcoholism, drug abuse, eating disorders, and other addictions. A significant percentage of divorces, spousal and child abuse, absenteeism from work, lost jobs, and bankruptcies are attributed to untreated depression."(Bloomfield et al., 1996)
ALLOPATHY
Time-Life (1996) summarizes the approaches to depression: selective serotonin reuptake inhibitors (SSRI) including fluoxetine, paroxetine, and sertraline; another neurotransmitter regulator called bupropion; lithium, as lithium carbonate; monoamine oxidase inhibitors and tricyclic antidepressants, like amitriptyline, desipramine, doxepin and nortriptyline. Imipramine, one of the most widely used tricyclics, has many side effects, many more than hypericum. If an analysis of 30 studies of antidepressants (including Prozac and why not herbal remedies which trigger the same chemical changes in the brain) is accurate, most of the antidepressant effect stems from the placebo effect. Guy Sapirstein, Westwood Lodge Hospital, Westwood MASS says, "How people think about an antidepressant drug and its effect on how they feel may influence improvement more powerfully than the chemical substance itself." Science News (150:123.1996) says "The placebo effect is twice as strong as either the pharmacological effects of antidepressants or ënonspecific factors, such as the passage of time." Sapirstein's quotes lead to one more effect, the "nopublo" effect, "An unknown number of studies in which antidepressants fail to outperform placebos are either not submitted or not accepted for publication." Scientists quoted maintain "Available data probably underestimate the placebo effect." (Anon. 1996. New pitch for placebo power. Sci. News 150: 123. 1996). There's a slightly different spin on videotaped conference of 225 depressed people and 28 therapists. The stronger the collaborative bond between therapist and patient, the greater the odds that the patient would improve. The therapeutic alliance made a bigger difference than the therapeutic method. (Consumer. Reports in Health 8(9): 106. 1996).
Prozac-like drugs work by altering the function of neurons that release the signaling neurotransmitter serotonin, which has been implicated in disorders of the sleep cycle, the sex drive and mood. Prozac-like drugs, because they inhibit reuptake of serotonin, are collectively known as selective serotonin reuptake inhibitors (SSRIs). SSRIs may have a 4 to 6-week lag time before they build up efficacy. (There are at least 14 known types of serotonin receptors.) I'd like to suggest, for my friends at any rate, dietary tryptophan and serotonin (If it can reach the brain from the stomach. I'm told that serotonin does not cross the blood brain barrier) as a gentler alternative to Prozac for depression, if not obesity, and some of the other problems for which cerebral serotonin seems to be indicated.
Dr. Joseph Pizzorno, N. D., Director of the John Bastyr School of Naturopathic Medicine, has managed to get many alternative therapies declared insurance-reimbursable in Washington State. He was praised for this accomplishment by former Surgeon General, C. Everett Koop. Since then he has outlined ten of his natural alternative recommendations. "The conditions for the body to heal depend on healthy diet, exercise, and attitudes. Herbs, vitamins and other substances often can stimulate healing, but unless the underlying reasons for the illness are corrected, improvement will be only temporary." Pizzorno recommends for depression daily exercise, 40 mg standardized ginkgo extract thrice daily in older patients or 300 mg St. Johnís Wort thrice daily. Pizzorno reminds us that he would not take the synthetics aforementioned, singling out maprotiline was no more effective than the Hypericum, yet it caused dry mouth, heart problems and tiredness. Pizzorno, J. E., Jr., 1996. 10 drugs I would never take . . . and the natural alternatives. Natural Health 26(5):82-5, 142-8.
HERBAL APPROACHES:
Bottle-gourd ( Lagenaria siceraria): These gourds are my richest reported source of choline, sometimes exceeding a calculated 1.6% choline ZMB. Fenugreek leaves can exceed 1.3%, shepherd's purse 1.0%. Horehound, ginseng, cowpea, english pea, mung bean, sponge gourd, lentil, and dong-quai are other herbs reported to attain as much as 0.2% choline ZMB (FNF, Duke, 1992). Choline and lecithin have been actively researched in depression, focussing on the cholinergic neurotransmitter system and the synthesis of acetylcholine from choline and acetylCoA by choline acetyltransferase. Choline's role as methyl donor deserves more attention. The blood brain barrier has a separate transport system for choline, which is more active than its systems for nucleosides (adenosine, guanosine etc.) or purine bases (adenine, guanine, etc.) (Levin, 1996; Rogers, 1995)
Chocolate (Theobroma cacao): In her new book, Why Women Crave Chocolate, Debra Waterhouse says chocolate can boost serotonin levels and boost endorphin levels with a powerful result "all brain chemicals are positioned at optimal levels for positive moods and renewed energy." Chocolate also contains phenylethylamine and is a good source of magnesium, important in serotonin manufacture and in stabilizing mood.
Eleuthero (Eleutherococcus senticosus): Farnsworth et al. (1985) note that eleuthero ginseng (Siberian ginseng) improves the sense of well being in depression, hypochondriasis, insomnia, and various neuroses. Siberian ginseng has been shown to increase monamine levels in the adrenals, brain and urine of rats.
Evening primrose (Oenothera biennis): An item in the July 20 (1994) Wall Street Journal (WSJ) could bring smiles to the faces of many depressed people, especially when they learn that the tryptophan in evening primrose, sunflower and pumpkin seed may help lessen their depression perhaps as well and surely as safely as the synthetic alternative Prozac. In Scientific American John Horgan (1996) reports that sales of Prozac topped $2 billion in 1995. While the WSJ article seemed to promote Prozac more than primrose, intelligent people might prefer the primrose path. Not necessarily convinced that the FDA invariably protects the consumer more than the corporate pharmaceutical firms, they might rather take tryptophan-rich seeds than Prozac and its me-too look-alike drugs for depression. Jaffe (1993) noting that in over 30 years of clinical use, L-tryptophan's safety record was remarkable until the eosinophilia-myalgia sundrome (EMS) epidemic, by contrast adds that 1.3-7.5% of all patients treated with Prozac, an alternative serotonin-enriching drug, are subject to potential persistent psychological side effects.
The best sources of tryptophan include some weeds and some foods. Evening primrose was highest in my database (2,500-16,000 ppm; the upper figure, though published, has not been reconfirmed), the lower figure is on a fresh weight basis, the higher figure is on a zero-moisture basis. I always like to verify superlative numbers like this, so I went back to my data source (Hudson, 1984) for the primrose data. In Hudson's Table II, he reports 1.60% tryptophan for the whole seed. That means the seed contains 16,000 ppm tryptophan. Wow!
Evening primrose oil is approved, at least in the UK, for symptoms of premenstrual syndrome. Tryptophan has been recommended for PMS as well. Nonetheless, back in the early 1990's the FDA banned tryptophan, an essential amino acid as a dietary supplement. One scientific review of tryptophan stated that it "is exceptional in its diversity of biological functions." It contributes to normal growth and protein synthesis in a number of tissues and regulates numerous physiological mechanisms. For example, tryptophan is the precursor of the neurotransmitter serotonin (5-hydroxytryptamine) and is therefore important in brain function. It can influence sleep in man and the aging process in rats. Tryptophan and some of its derivatives also alter behavior, particularly the regulation of the intake of food and drink. "Tryptophan serves as an in vivo precursor for niacin (also said to increase serotonin levels in the brain), and stimulates insulin and growth hormone secretion and prevents the development of cortisone-induced hypertension." (Journal of Agricultural and Food Chemistry;1988, p.1079-1093)
Keville (1996) suggests capsules of GLA, for relieving depression and anxiety. Borage, currant, evening primrose and hops are all well endowed with GLA (Duke and duCellier, 1993). Studies at the London Children's Hyperactive Clinic in England showed that evening primrose oil reduced depression and nightmares in children.
Ginger (Zingiber officinale): Tyler cites a long list of reputed roles for ginger; aging penile vascular changes, burns, hepatotoxicity, high cholesterol, depression, impotence, migraine, peptic ulcers, rheumatism, noting that evidence supporting such claims is, as yet, insubstantial. But the "herb does have a long-standing and apparently valid reputation as a digestive aid." Thus there are good reasons, including flavor, to add ginger to your herbal antidepressant. Ginger is also fairly well endowed with antidepressant nutrients. (ascorbic-acid 317 ppm; calcium 150 - 3,458 ppm; magnesium 430 - 2,690 ppm; phenylalanine 450 - 2,455 ppm; potassium 2,640 -25,079 ppm; tryptophan 120 - 693 ppm)
Ginkgo (Ginkgo biloba): Standardized extracts of ginkgo (to contain 24% ginkgoflavonglycosides) may be effective for depression, especially in cases of cerebrovascular insufficiency (DeFeudis, 1991). Extracts exert anxiolytic and antidepressant activity in several animal models (Porsolt et al., 1990). In a double-blind placebo-controlled study, European scientists (Schubert and Halama, 1993) gave 3 daily 80 mg doses of Ginkgo biloba extract to 40 older patients with cerebral dysfunction combined with episodes of depression not responding to antidepressants. Both their depressions and cognitive functions improved significantly. Ginkgo may be useful preventively and therapeutically, as with several other geriatric problems: intermittent claudication, macular degeneration, and resistant depression (Brown, 1994). Kleijnen and Knipschild (1992) state that the main indication for ginkgo is "cerebral insufficiency", characterized by twelve symptoms: 1. Difficulties of concentration. 2. Difficulties with memory. 3. Absent-mindedness. 4.Confusion. 5. Lack of energy. 6. Tiredness. 7. Decreased physical performance. 8. Depressive Mood. 9. Anxiety. 10. Dizziness. 11. Tinnitus. 12. Headache. In patients with clear dementia there are probably no positive effects with ginkgo treatment. (Kleijnen and Knipschild, 1992).
Kava-kava (Piper methysticum): Although Commission E reportedly contraindicates kava for "endogenous depression", my sources indicate that it might be studied as an herbal alternative for depression. I would certainly try it at bedtime, were I depressed, as an anxiolytic sedative. In one double-blind placebo-controlled study by Lehmann et al. (1996), 58 patients (43 females and 15 males) with anxiety were divided into two groups of 29 patients each. These patients were given either 100 mg t.i.d. of standardized kava extract WS 1490 (70% kava lactones) or placebo, for four weeks. Anxiety/depression decreased more with kava than with placebo. No adverse reactions were reported. Reichert (1996) notes that anxiety disorders are one of the most common psychiatric problems, with a lifetime prevalence of 15% of the general population. Considering the side effects of the usual benzodiazepinoids, fluoxetine and tricylclic antidepressants, "phytosedatives like kava represent a welcome option." Commission E warns against the concomitant use of kava with barbituates, antidepressant medications, and CNS agents.
St. John's Wort (Hypericum perforatum): ANECDOTE: Though St. John's Wort is a happy antidepressant herb, its accepted common name is depressing to authors and editors. Counting the possible capitalizations, the presence or absence of apostrophe, abbreviating saint or not, a period after st if you abbreviate, space or not after the period, space or not after john's, use of a hyphen here or there or not, I calculate that there are more than 100 ways the herb's name can be configured, defying all the search functions in my dysfunctional spell checker. That's why I'm going to call it hypericum from here on out, since not just one, but all species I have investigated contain hypericin, one major active ingredient. The common name commemorates St. John. Hypericum perforatum is usually in full flower (when best harvested) on St. John's Day, June 24. The scientific name Hypericum is said to reflect its heather-like appearance or association with heathers, at least in my unabridged dictionary, from hyper (over) and erikn or ereikn (heather). A 1995 review offers three alternative explanations. It comes from hyper (over) and eikon (image), (1) from the image that appears on the flowers, or (2) that the image means ghost, because of its exorcistic connections or that it comes from (3) upereidofal (I see beyond, I show myself), from the transparent dots on the leaves. I prefer the magical exorcistic interpretation for it is a magic herb, smiling as it does on St. John's Day, and later when those transparent pores become filled with the symbolic blood of St John.
For months I asked, more than a dozen scientists, who should know, if dietary serotonin could increase cerebral serotonin, as dietary tryptophan does. I was turned on because the convoluted meat of the walnut, richest source of serotonin, resembles the brain. Finally, months after pondering this problem, I received a nice line of reasoning from Dr. Jerry Cott of NIMH , "Dietary intake of neurotransmitters will not reach the central nervous system (CNS) for a couple of reasons: 1) they are metabolized very quickly by MAO in the liver; and 2) they cannot get through the blood-brain barrier. The only things that can get into an intact CNS are lipid soluble compounds or other compounds which have active transport systems, such as many amino acids. Thus the precursor amino acids (like DOPA and tryptophan) can get through. If you inhibit MAO you can get even more through due to higher blood levels." (Cott, J. pers. comm. May 15, 1995). One abstract cited by Werbach (1991) makes the serotonin look better than the tryptophan. In a review article, van Praag (1984) concludes that 200 mg L-5-hydrodroxytryptophan taken daily with 150 mg carbidopa was effective for depression, while 5 g tryptophan was no better than placebo. Reichert (1995) states categorically "It is clear that St. John's Wort extract raises serotonin levels."
I was surprised to read in Rational Phytotherapy (Schulz et al., 1998) that much of the herb used in Germany is obtained by controlled cultivation (Germany, Poland, South America). There was a shortage over here, when the media blitz hit last summer, and Hypericum jumped to the top of the charts. Even my usual roadside weedy stands were depauperate, having dried up in the dry June and July of 1997, with some going into a second flowering spurt after the drought ended. Hypericum grows wild as a weed in Asia, Europe, North and South America, especially in dry sunny situations, like clearings for construction, railways and roads. I keep planting several species at my Herbal Village, but they seem to have a mind of their own, coming up where I didn't plant them. Matter of fact, our local Hypericum punctatum seems to have more of the reddish compounds than my Hypericum perforatum. It wouldn't surprise me if it had more antidepressant activity as well. Just crushing the leaves of H. punctatum stains my fingers purplish red, it usually takes the flowers of H. perforatum to stain my fingers. Both species (and several others) are clearly weeds around Maryland, the H. punctatum better adapted to less sun.
Nature's Herbs suppliers know the secrets to preserving quality phytochemicals in the herb. They should be gathered when in flower, the material then swiftly but carefully dried to preserve the phytochemicals in the glands that give the plant its dotted appearance. Some liken the dots on the leaves to the pores of St. Johnís skin, and the reddish phytochemicals to the blood of St. John. (that purplish stain results from characteristic phytochemicals - hypericin, pseudohypericin, protohypericin, protopseudohypericin, and cyclopseudohypericin. Dried plants contain only about 1,000 ppms of these compounds) Drying temperatures should not exceed 30-40 degrees C. Low hypericin lots are discarded.
Murray (1994) notes that components in Hypericum alter brain chemistry in a way that improves mood. Clinical research shows it relieves depression. Clinical studies show that the extract (with 1,250 ppms hypericin), significantly improves symptoms of anxiety, depression and feelings of worthlessness, better than the standard antidepressant drugs like amitriptyline (Elavil) and imiprimine (Tofranil), which often induce drowsiness, dry mouth, constipation, and impaired urination. While not clearly associated with any negative side effects, Hypericum also improves sleep quality (one of my anecdotal correspondents has attested to this). Patients on hypericin show an increase in a major urinary metabolite of norepinephrine, suggesting to Werback (1993) that St.Johns-wort may increase brain levels of norepinephrine, an antidepressant. Other scientists have found that the extract LI160 strongly inhibited norepinephrine and serotonin uptake in mouse brain preparations. With rats the IC50 was only 6.2 ug/ml for inhibiting synaptosomal serotonin uptake. (consistent with doses of 900 mg extract in humans). Not only does it inhibit the neuronal uptake of serotonin, it down regulates serotonin receptors. Other studies showed neurohormonal and/or neuroimmunologic activities. With understatement they conclude "Since hypericum extracts, unlike synthetic chemical antidepressants, represent a natural mixture of the constituents of St. John's Wort, it is not surprising that the herb could have various potential mechanisms of actions."
Of depression outpatients, randomly receiving hypericum extracts or placebo, 67% improved on the extract compared to 27% on placebo. Although 2 had minor side effects, there was no observed diminution of cognitive performance. (Schmidt and Sommer, 1993)
In Germany, all Hypericum antidepressants are based on alcoholic extracts, with the herb:extract ratio 4:1 to 7:1. The successful European clinical trials were all based on extracts using ethanol or methanol as a solvent. Highest yields of active principles were obtained with aqueous methanol (20-40% water), done in darkness, with temperatures rising briefly no higher than 80 C. The best German trials were on the LI160 extract. Ingestion of 300, 900, and 1800 mg raw extract affording 250, 750 and 1,500 ug hypericin (according to their Fig. 2.8 but the legend seems erroneous) led to maximum plasma levels of 1.3, 17.3, and 66.3 ng/ml hypericin and 7.1, 28.4 and 48.0 ng/ml pseudohypericin. Elimination half-life was dose dependent, about 24-48 h for hypericin, 18-24 for pseudohypericin. Plasma levels were measurable 2-3 h and 15-30 min after ingestion respectively of hypericin and pseudohypericin.
In most double-blind placebo-controlled studies, a charismatic physician alone can improve 10-40% of patients, as usually quantified in depression scales (Hamilton Depression Rating Scale). Pharmacotherapy can increase improvement to 60-80%. "This casts doubt on the validity of clinical studies that are conducted without benefit of double-blind control groups." (Schulz et al., 1998) St. John's Wort has proven effective for various depressive mood disorders "including moderate and severe depression. (That severe depression is rarely reported) A daily dose of 900 mg. . .adjusted to 0.3% total hypericin should provide therapeutic efficacy similar to that achieved with modern synthetic antidepressants."
NUTRITION
As a distant second or complement to exercise and Hypericum, you might try the nutrients Andy Weil (1996) recommends, 1,500 mg DL-phenylalanine (less if hypertensive), 500 mg vitamin C, 100 mg vitamin B-6 in the AM, with fruit or juice, 45 minutes before breakfast. In the evening, 500 mg more vitamin C and 100 mg vitamin B-6. By contrast, Time-Life (1996) suggests that 800 mg S-adenosylmethionine, 400 ug folic acid and vitamin B complex are useful in treating depression. When the diet is selenium deficient, a supplement of 100 ug was shown to elevate the mood. (Time-Life 1996). Two average brazilnuts would give you more than 100 ug selenium.
As Murray (1994) notes, methionine, administered as S-adenosyl-methionine (SAM) was superior to motrin (ibuprofen) in treating osteoarthritis in double blind clinical trials but SAM was antidepressant in rheumatoid arthritics. "Although SAM is not available in the United States, an equivalent amount of methionine (250 to 500 milligrams of L-methionine three times daily) may produce similar results. But, the best recommendation may be to eat more methionine- and sulfur-rich foods like legumes, nuts, seeds and whole grains." Werbach's suggestions (1993) differ rather markedly from Murray's. Werbach notes the major antidepressant role of norepinephrine, derived from the amino-acid L-phenylalanine. In trials of depressed patients taking L-phenylalanine and vitamin B-6, more than 75% showed improvement. Werbach suggests starting with 500 mg L-phenylalanine upon arising and at noon, working up to 2 g, twice a day, if tolerated, combined with 50 mg vitamin B-6.
My postdoctoral assistant, Dr. Stephen Beckstrom-Sternberg, devised a simple computer program by which he can determine in which minerals, vitamins and other compounds a given species excels. They are not just above average, like the kids of Lake Wobegone; as the postdoc puts it, they are "2 or more standard deviations above the mean". Purslane stood out for two antidepressant elements, magnesium and potassium. Stephen also designed another query, which lists the plants that are richest in antidepressant elements and compounds from the FNF database. Purslane is among the top five at 13.5%, topped off by lettuce, with its calcium, folic acid, lithium, magnesium, norepinephrine, phenylalanine, potassium and tryptophan, adding up to a possible high total of 16% "antidepressant" compounds on a zero-moisture basis. Matter of fact, the top five are all salad ingredients, to make up an unSAD SALAD: lettuce, pigweed, purslane, lambsquarter, and watercress, in decreasing order of total antidepressants. One recent phone call would induce me to add thyme to the salad. The caller, perhaps worried about taking lithium drugs, called to ask which herbs were highest in lithium. I told him I assumed that all plants contained lithium, but that some might accumulate it above natural gradients. My print out shows that at 4 ppms, thyme has the highest reported lithium content among plant parts that are normally consumed (we don't normally consume hickory and oak shoots which were slightly higher). If my sources are accurate and reflect the real world, bean soup flavored heavily with thyme, chased with an orange/grapefruit cocktail, might be the food "farmacists" recommendation for herbal lithium. We need many more reliable analyses before any such recommendations should be made. Perhaps readings of 4 ppm are reasonable. The Merck Index (11th ed.) notes that the earth's crust is 0.005% lithium by weight, which I translate to 50 ppm. The herbal approach is almost homeopathic compared to normal dosages, for example, lithium carbonate is usually prescribed at levels of 1 to 2 grams a day, for mania. If a kilogram of thyme had 4 mg of lithium carbonate, it would take 500 kilograms of dry thyme to provide that 2-gram dose (I only weigh 110 kilos). I'll still sprinkle some thyme on my unSAD SALAD.
There's one good reason to snack on sunflower seeds with your bean and watercress soup. These are the three richest sources (ZMB) of phenylalanine, with sunflower containing up to 4.8%, and black bean and watercress containing up to 2.3%. Pigeonpea and soybean are close behind with up to nearly 2.1%. To get 500 mg phenylalanine from sunflower might require a pound of fresh low-phenylalanine sunflower, but a 100 g USDA serving of dry sunflower seed could provide 480 mg. You might make Sunny Soup for Depression, with ground sunflower seeds, plus black beans and watercress for phenylalanine, mustard greens and a mix of beans and spinach for tyrosine, which is also an antidepressant and monoamine precursor.
LIFE STYLE
Dr. Andrew Weil, M. D. from Harvard, distinguished author of several books and the new newsletter, Self Healing, says in his first issue: "Aerobic exercise is actually the best antidepressant I know, provided it is done vigorously enough and often enough...It increases production of endorphins, the brains own opiate-like molecules that are associated with some of our best natural highs...You must do thirty minutes of sustained aerobic activity at least five days a week...If you are prone to depression, exercise of this sort is also the best preventive."
REFERENCES
ABC. 1994. Herbs and Health - An Introductory Guide to Herbal Healthcare. 8 pp. American Botanical Council, P.O. Box 201660, Austin TX 78720.
Bloomfield,HH; Nordfors,M; and McWilliams,P. 1996. Hypericum & Depression. Prelude Press, Santa Monica. 90046. 203pp..
Bombardelli, E. and Morazzoni, P. 1995. Hypericum perforatum. Fitoterapia 66(1):43-68.
Brown, D. 1994. Ginkgo biloba Extract: Efficacy in Early Stage Alzheimer's Disease. QRNM(Wint.) 297-8.
Cott, J. 1997. Pharmacology of Hypericum perforatum. Typescript. NIMH.
Cott, J (1997). In vitro receptor binding and enzyme inhibition by Hypericum perforatum extract. Pharmacopsychiatry 30 (Supplement):108-112.
Cott, J. 199? In Vitro Receptor Binding and Enzyme Inhibition by Hypericum perforatum Extract.
DeFeudis, F. V. 1991. Ginkgo biloba extract (EGb 761), Pharmacological Activities and Clinical Applications. Elsevier, Paris.
Farnsworth, N.R. et al.. 1985. Siberian Ginseng (Eleutherococcus senticosus): Current Status as an Adaptogen. Econ.& Med. Pl. Res. 1:156-215.
Horgan, J. 1996. Field Notes- Headshrinker Convention. Sci. Am. (July, 1996. P. 26.)
Hudson, B. J. F. 1984. Evening Primrose (Oenothera spp.) Oil and Seed. JAOCS 61(3): 540-543.
Keville, K. 1996. Rodale Press.
Kleijnen, J. and Knipschild, P. 1992. Ginkgo biloba. Lancet 340:1136-1139.
Lehmann E, Kinzler E, Friedemann J. Efficacy of a special kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental originóa double-blind placebo-controlled study of four weeks treatment. Phytomed 1996; 3:113-9. Rev. by Reichert R; QRNM (Winter 1996) p. 249-50
Levin, B. 1996. Diet, methyl group donors, and cancer. QRNM(Spring): 37-8.
Murray, M. T. 1994. Natural Alternatives to Over-The-Counter and Prescription Drugs. Wm. Morrow & Co., Inc., New York. 383 pp.
Porsolt, R.D. et al. 1990. Effects of an Extract of Ginkgo biloba (EGB 761) on "Learned Helplessness" and Other Models of Stress in Rodents. Pharm. Biochem. Behav. 36: 963-971.
Reichert, R. G. 1994. St. John's Wort for Depression. QRNM(Spring) 17-8.
Reichert, R. 1995. St. John's Wort extract as a tricyclic medication substitute for mild to moderate depression. QRNM Winter 1995. p. 275-4
Reichert R. 1996. Treatment of anxiety with kava-kava. Quarterly Review of Natural Medicine; Winter: 249-50. 1996. (Review of Lehmann paper.)
Rogers, A. E. 1995. Methyl donors in the diet and responses to chemical carcinogens. Am. J. Clin. Nutr. 61(Suppl.): 659S-665S
Schubert, H. and Halama, P. 1993. Depressive Episode Primarily Unresponsive to Therapy in Elderly Patients: Efficacy of Ginkgo biloba extract (EGb 761) in Combination with Antidepressants. Geriatr. Forsch. 3: 45-63.
Schulz, V, Hansel, R and Tyler, VE. 1998. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. 3rd ed. 1st English Edition. Translated by Terry C. Telger. Springer Verlag, Heidelberg. 306 pp.
Time-Life, editors. 1996. The Medical Advisor. The Complete Guide to Alternative & Conventional Treatments. Time Life, Inc., Alexandria Va. 1152 pp. (Cited as TMA, 1996)
Tyler, V. E. Herbs of Choice - The Therapeutic Use of Phytomedicinals. Pharmaceutical Products Press, New York. 209 pp. 1994.
Tyler, V.E. 1997. The Honest Herbalist - The secrets of Saint-Johnís-Wort. Prevention (Feb.): 74-79
van Praag, H. M. 1984. Studies in the Mechanism of Action of Serotonin Precursors in Depression. Psychopharm. Bull. 20(3): 599-602.
Weil, A. 1996. Relieving Depression Simply. Self Healing 1(1): 8.
Werbach, M. 1991. Nutritional Influences on Mental Illness - A Sourcebook of Clinical Research. Third Line Press, Inc. Tarzana CA. 360 pp. (counting the advertisements)