The World Health Organization estimates that 80 % of the world's population relies on natural medicines. Now the United States is rapidly catching up, to the point at which natural supplements are readily found in most pharmacies and supermarkets. Eisenberg's oft-quoted 1998 Journal of the American Medical Association paper reported that from 1990 to 1997, the use of complementary and alternative medicine (CAM) rose from 34% to 42%, while herbal use quadrupled from 3% to 12% It is worth remembering that these rapid changes have come not through the medical profession but by popular demand. In the Eisenberg survey, two of the top five conditions for which consumers sought alternative treatment were anxiety and depression. In addition to Hypericum perforatum (St. John's wort)-the main natural remedy featured in the present discussion-other herbs are also increasing in popularity for addressing these and related problems. These herbs include Ginkgo biloba (ginkgo) for senile dementia or benign forgetfulness, Panax spp. (ginseng) for stress and fatigue, and Valeriana officinalis (valerian) for insomnia. In addition to St. John's wort, this review covers two nonherbal supplements for which there are supportive data for their use in treating depression: omega-3 fatty acids and Sadenosyl -L-methionine (SAMe).
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