It appears, furthermore, that the studies which showed the lack of efficacy of St. John's Wort were funded by NIH-CAM, (not by Pharma, which could be always suspected of aggressive and frankly corrupted bias in today's climate!), which I understand is generally pro-safe CAM rather than anti-CAM, so unless one suspects too an extraordinary level of corruption or bias within NIH-CAM itself (I guess anything is possible nowadays, so one never knows!)...one can safely assume that it just doesn't work very well.
Of course, SSRI's themselves are not that extraordinarily effective, as we have all witnessed during more recent revelations...so...one may ask...what's a doc to do? Take TIME, IMHO, to both learn how to CRITICALLY read the literature, and also to unravel, as best as possible, case by case, what may be helpful and what may not in the case of each individual patient, how to prioritize and optimize the various tx. tools currently at our disposal (and we are all very aware that these are not limited to pills!), and just plain try to treat what is treatable, and improve what's improvable, as best as we can, under the traditional and perennialy worthy of supporting paradigm of "first do no harm"!
