Omega-3
There has been much research conducted examining the relationship between omega-3 and depressive disorders, with some limited evidence that omega-3 fatty acids (primarily found in fish and seafood) have antidepressant effects [1152–1154]. Although there are some indications that omega-3 fatty acids have a beneficial role in reducing dependence, cravings, and stress among people with AOD use disorders [1153], findings are inconsistent and most research to date has been conducted on animals [1152, 1154]. Further, the role of omega-3 fatty acids among people with co-occurring AOD use and depression has not been rigorously examined.
St John’s Wort
St John’s Wort is the common name for the plant Hypericum perforatum, the extracts of which are commonly used to treat depression, sometimes in order to avoid the side-effects involved with prescription antidepressant medication [1155]. Systematic reviews of studies examining the efficacy of St John’s Wort found significantly greater reductions in mild to moderate symptoms of depression among those taking St John’s Wort compared to placebo, and equivalent reductions compared to antidepressant medications [1156, 1157]. However, the long-term side effects, particularly among pregnant women, are unknown.
Although there is some evidence of efficacy in mild to moderate depression, as described in Chapter B6, the use of St John’s Wort has been shown to have significant interactions with a range of other medications, including SSRIs and related drugs, oral contraceptives, some anticoagulants, and some cardiac medications [794].
Although the use of St John’s Wort among people with co-occurring AOD and depressive disorders has not been examined, AOD workers should ask their clients specifically about their use of St John’s Wort and other complementary medicines, taking note of the potential for interactions between medications.