Psychiatrists' experience and views regarding St John's Wort and 'alternative' treatments

Objective: This study aims to ascertain the experience and views of psychia trists in relation to St John's Wort and alternative treatments generally, Method: A questionnaire was posted to all members of the Royal Australian a nd New Zealand College of Psychiatrists living in Australia or New Zealand, Results: Of the 1910 mailed questionnaires, 862 (45%) were returned, Eighty per cent of respondents had patients who had used the herb. Side-effects a nd drug interactions were reported by 28% and 8% respectively of these psyc hiatrists. Some adverse events were described as serious. Psychiatrist atti tudes about St John's Wort and alternative treatments were positive overall and psychiatrists seemed willing to recommend St John's Wort despite limit ed evidence of its usefulness. Conclusions: Psychiatrists in Australia and New Zealand regularly manage pa tients who take St John's Wort and a considerable number actually recommend the treatment. However, they also report side-effects and drug interaction s. Psychiatrists should routinely enquire about their patients' use of alte rnative treatments, be mindful of possible side-effects and in particular b e aware of the dangers of combining St John's Wort with other psychotropics .