It may seem odd that drugs can produce a side effect in some individuals but not in others. Yet each of us has a unique brain and body biochemistry. For reasons that are still not totally understood, certain people respond better to one medication than another. They may have a more pronounced reduction in their depression, or not have any side effects to speak of. Another person could take the same dosage and have quite different results. Consequently, the selection of the best antidepressant medication is often a matter of an educated guess, followed by trial and error, for the psychiatrist.

For many people, particularly those who come to me for a change to St. John's wort, the side effects they experience are so intense-or the expense is so high-that they prefer to stop synthetic medications altogether. Jan, Jeremy, and Will can all testify to this.

Jan: "I've suffered from dysthymia all my life. What worked for me was to drink a lot, until alcoholism stopped that dead in its tracks. Then came Prozac. It worked OK, but I couldn't stand the side effects. Then I took Zoloft for three months, 100 milligrams a.m. and 100 milligrams p.m. It worked. It cost a lot. I am also not sure I liked the leveling off of all my emotions! So, a month ago I began substituting St. John's wort, two tabs at night instead of the two doses of Zoloft. I'm very happy with the results. I no longer suffer debilitating PMS, either."

Jeremy: "I was on Prozac for two years and just about went broke buying it. I then switched to Wellbutrin and that was much better on my pocketbook than Prozac. I then switched to St. John's wort, a German brand, at about $24 for sixty 300-milligram tablets. I then found out that I could get the same thing made in the States for seven dollars. That is where I am now, and I feel great! With no side effects at all!"

Will: "My wife was on Prozac. It led her to have an 'I don't give a damn' attitude about important things, and to stomach distress the entire time she was on it. She then went off Prozac and started on St. John's wort. The stomach distress went away the day she stopped Prozac. Now that she's on her 'wart,' as she calls it, she is relaxed and cares about the important things in her life."

In many cases, besides the side effects, synthetic antidepressants produce subtle emotional results: complaints of flatness, of not caring, of dulled emotional responses. St. John's wort, in contrast, produces none of these effects. It not only counters the depressive feelings, but allows a natural brightness of emotion and sharpness of mental functioning to emerge.

That is why I prefer to use natural products such as herbs whenever possible. They have been used for thousands of years and have a much better safety record. In fact, when herbs do affect systems other than the targeted system, those extra effects are often positive in nature. Also, the multiple components in herbs are usually at a low enough concentration that they don't affect any one area too strongly. Their healing power is due to the synergistic effects produced by the combination of components. That is the very beauty of herbs. They promote balance and healing.

To summarize the benefits of St. John's wort when compared with synthetic antidepressants:

• Its side effects are not nearly as severe, and far less frequent.
• It does not have adverse effects when mixed with alcohol.
• It is non-addictive.
• It does not produce withdrawal symptoms when you stop taking it.
• It does not produce habituation, or the need for increased dosages to maintain its effects.
• Its use can easily be restarted without requiring a long buildup period.
• It enhances sleep and dreaming.
• It does not produce daytime sedation. In fact, it has shown experimentally to enhance alertness and driving reaction time.
• It does not produce agitation or instability.