As it is now, St. John's wort is an unregulated nutritional supplement not approved by the Food and Drug Administration for medical purposes - which means there are no guarantees about the compound's quality or purity. The Duke study will go beyond most of the European studies and follow patients longer - for 26 weeks. Most anti-depressants begin to work after a few weeks. Dr. Murali Doraiswamy, who will direct the trial's Duke site, said more research is needed so that doctors can educate their patients on when and how they should use St. John's wort. One theory is that it works like other anti-depressants, that is, it raises serotonin levels.
Some people theorize that it works on other chemicals in the brain.
Researchers hope their study will enable them to help educate the public on how to use the herb safely and effectively. Currently, thousands of people in the United States are taking St. John's wort with no supervision and few guidelines about correct dosages. Rezvani cautions that if St. John's wort works for humans, it will be only one tool in combatting alcoholism. Alcoholism is a complex disease. It takes family support, social support, therapy - all of that should be part of the treatment.