Abstract
Objective: To ascertain the experience and views of psychiatrists in relation to St. John's Wort and alternative treatments generally.
Method: A questionnaire was posted to all members of the Royal Australian and New Zealand College of Psychiatrists living in Australia or New Zealand.
Results: Of the 1910 mailed questionnaires, 862 (45%) were returned. Seventy-nine per cent of respondents had patients who had used the herb. Side effects and drug interactions were reported by, respectively, 28% and 8% of these psychiatrists. Some adverse events were described as serious. Psychiatrist attitudes about St. John's Wort and alternative treatments were positive overall and psychiatrists seemed willing to recommend St. John's Wort despite limited evidence of its usefulness.
Conclusions: Psychiatrists in Australia and New Zealand regularly manage patients who take St. John's Wort and a considerable number actually recommend the treatment. However, they also report side effects and drug interactions. Psychiatrists should take an active interest in their patients' use of alternative treatments, but be mindful of side effects and particularly about the dangers of combining St. John's Wort with other psychotropics.