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St john's wort in the elderly: greta’s story ST JOHN'S WORT IN THE ELDERLY: GRETA’S STORY
When Greta, a 69-year-old woman referred to Professor Volz by her GP, was asked what was troubling her, depression was the furthest condition from her mind. Instead she complained of many physical ailments - headache, stomach ache, tiredness and an unpleasant taste in her mouth. Her GP had been unable to find any physical explanation for these symptoms and the only abnormality he could detect was a slight problem with cardiac conduction, as measured by EKG. She had complained of sleep difficulties, for which she had been treated with sleeping pills with some success.
When Dr Volz questioned her, it became apparent that her difficulties had begun about two years before, shortly after her husband died unexpectedly of a heart attack. Despite having enough money and a close relationship with her son, who lived in the same town and visited her twice a week, Greta complained of sadness and hopelessness but, she hastened to add, 'only when I am alone'. Dr Volz tried to explain to her that her symptoms might be due to depression, but she vehemently objected to such an explanation. When he suggested that she might benefit from a drug such as Prozac, she refused to take any synthetic antidepressants, insisting 'that's all chemical stuff.' After two further visits with Dr Volz, he suggested that she might try St John's Wort. To his astonishment, she immediately agreed to take this because 'herbs are not dangerous.'
Dr Volz started Greta on St John's Wort at a dosage of 900 mg per day. He noticed no improvement until she had been on the herbal remedy for six weeks, and it took another 10 weeks before Greta's symptoms were reduced to a significant degree. Greta remains convinced that the improvement she has enjoyed on St John's Wort has nothing to do with relief from depression but rather to 'non-specific' effects of the herb. Dr Volz feels no need to challenge this belief. She is no longer depressed and her mood has been stable without any adverse effects whatsoever - reward enough for a caring doctor.
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What your doctor should know; women tell their stories