Health drugs recommended for depression lack sound scientific backing

According to a new study the majority of drugs recommended by health shops to treat depression have no sound scientific backing.

Experts at Leeds General Infirmary say a more integrated approach is needed after they found only 1 in 13 recommended drugs - St John's Wort - had any evidence to support use for moderate depression.

The researchers surveyed 10 health food shops within three miles of Leeds city centre for their recommendations on treating mild to moderate depression and found that staff were unlikely to warn customers about the adverse side effects of the drugs.

The recommended health remedies included ginseng, royal jelly and cat's claw, and these along with others including vitamin B complex, Bio-Strath liquid tonic, Floradix liquid tonic, Gingko Biloba, Guarana, and multivitamins had no firm evidence base and had "potentially serious drug interactions".

Joyce Reed, a senior house officer at St James' University Hospital in Leeds and Peter Trigwell, a consultant in liaison psychiatry at Leeds General Infirmary, say their findings raise concerns about the virtually complete separation and independence of complementary and alternative medicine services from the National Health Service and pharmaceutical agencies.

During visits or telephone calls to 10 health shops by a test customer, when symptoms such lethargy, lack of concentration, poor appetite and disturbed sleep were described, most of the staff asked extra questions before putting forward recommendations but only two asked the customer if they had consulted their GP.

Furthermore staff made no response when the "customer" explained she was taking the oral contraceptive pill, despite evidence St John's Wort can reduce its effectiveness.

Only one staff member explained she was not medically trained and that it would be wise to see a GP first.

The authors suggest a more integrated approach would allow patients to benefit from herbal preparations, such as St John's Wort, with optimum safety and many herbal remedies may have beneficial properties which could be used to great advantage if an adequate evidence base was developed.

The study is published in the Psychiatric Bulletin from the Royal College of Psychiatrists.