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SUPPLEMENTAL REMEDIES
Perhaps the most popular alternative remedy for depression is St. John's wort. Although two recent studies found it didn't work as well as a placebo in alleviating major depression, the herb has shown promise in treating mild depression.
Side effects include nausea, heartburn, insomnia and an increased sensitivity to sunlight. It also can weaken the effect of prescription medications, such as the blood thinner warfarin, the heart medication digitalis, some AIDS drugs and oral contraceptives.
Still, "people should consider it as an option, especially if they haven't done well on other medications," says Dr. David Mischoulon, a psychiatrist at Harvard Medical School.
Another dietary supplement, SAM-e, may also help combat depression. Produced from a yeast derivative, SAM-e was introduced to the United States in 1999. Backed by 40 studies done in Europe, the over-the-counter remedy was touted as a fast-acting antidote to depression with none of conventional medication's side effects. Some depression sufferers find SAM-e (short for s-adenosylmethiodine, a substance found naturally in the body that is believed to fuel dozens of biochemical reactions) more tolerable than the usual SSRI drugs.
Timothy Dickey, a 33-year-old Los Angeles writer, took Prozac for more than a year but didn't like the numbing effect had on his emotions, or the dry mouth and mild anxiety it caused. With SAM-e, he says, his depression vanished within days.
"I feel more resilient and fortified against the daily stresses of life that in the past would have gotten me down," says Dickey, who takes a 20-milligram tablet each day.
Growing anecdotal reports about the efficacy of SAM-e, which seems to work by enhancing the action of two mood-regulating brain chemicals-serotonin and dopamine, have prompted mainstream doctors to take a look. Harvard researchers are now testing the supplement in combination with SSRIs, such as Prozac and Zoloft, on severely depressed patients whose symptoms aren't eased by conventional drugs.
SAM-e, however, may trigger episodes of mania in people with bipolar disorder. It's also difficult to know if you're getting a therapeutic dose of SAM-e in supplements sold in health food stores.
"A few brands are OK," says Dr. Richard P. Brown, a Columbia University psychiatrist who has used SAM-e successfully on several severely depressed patients who didn't respond to antidepressants. "But a lot of them are mediocre or worthless. That's why people should consult with their doctors before they use them."
ACUPUNCTURE
Acupuncture may be an effective mood enhancer. In a 1999 study conducted by University of Arizona researchers, 34 women suffering from major depression who underwent eight weeks of acupuncture treatment reported an elevation in mood similar to that provided by antidepressants. The finding reinforced earlier studies in the former Soviet Union and China. The Arizona researchers, along with scientists at Stanford University, are conducting a larger study of 150 women.
"While the initial results were encouraging," says Rachel Manber, a Stanford University psychologist and research team member, "they aren't conclusive. . . . But this might be a viable option for women who are pregnant or lactating and don't want to take medication."
RX: EXERCISE
Numerous studies have shown exercise to be an excellent antidote for mild to moderate depression. And over the long haul, researchers say, it may work better than medication in controlling symptoms.
"We still don't understand the mechanisms behind this -- whether it's a change in brain chemistry or they just feel better because they mastered something challenging," says James Blumenthal, a Duke University psychologist and co-author of a 2000 study on the long-term effects of exercise.
"But we do know it works."
Duke researchers studied the effects of exercise on 156 volunteers older than age 50 who were diagnosed with a major depressive disorder. The test subjects were given a regimen of exercise, medication or a combination of both.
After 16 weeks, all three groups' progress against depression was similar, although those who took anti-depressants got faster relief from their symptoms. But a follow-up study 10 months later found exercise groups had a significantly lower relapse rate than those on medication only. And the more participants exercised, the better they felt.
That's certainly what happened to Gary Watkins. Every winter, the 56-year-old Durham, N.C., man would lapse into an ever-deepening funk as the days got shorter. He tried medication, but it stunted his emotions so he stopped taking it. Yet he knew he had to do something.
Enrolling in the Duke University study got him started on a regular exercise regimen that he continues.
"It's hard to get yourself moving when you're depressed,' says Watkins, who still works out on the treadmill on his lunch hour and runs cross-country. "But for me, exercise is the best way to control my depression."
Source: Los Angeles Times
next: Mind/Body Medicine for Treating Depression
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