A recent study reported the annual cost of depression in the US to be approximately $43 billion a year. This amount includes the cost of treating the condition and the loss of productivity and positive contribution to the economy resulting from the illness. Even without taking into account the human suffering involved in the condition, depression is considered to be one of the ten costliest conditions to any nation’s economy.
While depression is costly, its treatment is lucrative. Thus, the anti-depressants such as Prozac and Lustral are among the best-selling medications, representing billions in revenue for their manufacturers. While these medications can literally be life-savers, those who offer these commodities have a marked vested interest in maintaining their share of the market. They might be understandably concerned by the advent of an effective, off-prescription alternative treatment for depression. While some concerns about this new way of treating depression are warranted, others may be suspect, motivated by an attempt to protect economic turf.
In all cases, arguments against the self-administration of St John’s Wort need to be considered on their merits. For example, a leading psychiatrist was quoted in a recent article in the Washington Post on St John’s Wort as saying, ‘If a drug has enough activity to actually treat something that is real and substantial, then it ought to be administered under somebody’s supervision.’ If you consider the many active drugs available without prescription, which are routinely self-administered to treat real and substantial problems, such as aspirin for arthritis or antihistamines for allergies, it is clear that this argument is not universally applied in other areas of medicine. Nor, in my opinion, does it necessarily apply in psychiatry either. Perhaps the psychiatric establishment has yet to get used to the novelty of an over-the-counter treatment for depression.