PREGNANT WOMEN WARNED ON TAKING HERB FOR DEPRESSION

Saint Johnswort could increase risk of premature delivery, specialist says

Kohler -- Women who take Saint Johnswort for depression during pregnancy may
be increasing their risk of premature delivery, a women's health specialist
cautioned.

Linda Chaudron, a physician in a women's health fellowship at the University
of Wisconsin Medical School, said studies in mice have found that the herbal
medication Saint Johnswort increased contractility of the uterus.

In a presentation before the psychiatrists attending the Wisconsin
Psychiatric Association's spring meeting last week, and in a later
interview, she said this raises the specter of premature contractions in
women who take the over-the-counter herbal product.

Although no cases of premature delivery in women using Saint Johnswort have
been documented, Chaudron thought it wise that women not use the substance
without physician approval.

"Many people think it is less risky because it is an over-the-counter drug,
but that is not always the case," she said. She said there are many
different Saint Johnswort products being sold and the consumer often does
not know the purity or strength of the preparation.

Saint Johnswort has become a popular remedy for mild-to-moderate depression
here and in Europe, after a German study indicated it was useful in such
instances. It's increased use has drawn intense media attention.

Chaudron said the problem of depression and related affective disorders is a
large one. The likelihood an adult will suffer at least one instance of such
a disorder in a 12-month period in the United States is 10%.

Psychiatrist Arnold Lieber, a national advice columnist on depression and
related topics, said in a phone interview that there was no data "whatsoever
on the safety of its use (in pregnancy) at this time. Therefore it follows,
that hypericum (Saint Johnswort) should be avoided during pregnancy."

Howard Buckingham, a local clinical herbalist at Complete Health Services, a
natural healing clinic, said he would not recommend that any herb be taken
during the first trimester of pregnancy.

Furthermore, he said, pregnant women should avoid standardized extract of
the herb at any point during the pregnancy. Standardized extract is the most
potent form, which is derived from the plant's blossoms. However, he said,
herb capsules that use whole ground plant would be acceptable.

Chaudron, speaking on prescription drugs used to treat these problems during
pregnancy, she said that generally, the benefits outweigh the risks.

Removing the drugs increases the possibility that the patient will develop
emotional symptoms severe enough to prevent them from eating, causing
malnutrition; withdrawal that keeps them from seeking prenatal care; or lead
to drug and alcohol use -- all conditions that will prove more risky to
mother and child than the drugs, she said.

The newest anti-depressants such as Prozac, Zoloft, Paxil, Effexor appear to
be the safest. Studies have indicated they do not cause birth defects or
behavioral problems in children whose mothers use them.

Lithium, used to treat bipolar disorder (formerly manic/depression) does
carry a 1% to 2% risk of a serious heart defect developing in the fetus, she
said. But again, the benefit may still outweigh the risk.

Chaudron also said people with emotional disorders during pregnancy are at
higher risk of developing postpartum depression than normal patients,
another reason why medication should continue.

Most of the anti-depressants can be used safely while breast-feeding, while
lithium should not be used. However, there are two other drugs -- valproate
and carbamazepine -- that can be substituted for lithium, she said.