Pubdate: Thu, 18 Nov 1999
Source: Irish Times (Ireland)
Copyright: 1999 The Irish Times
Contact:  11-15 D'Olier St, Dublin 2, Ireland
Fax: + 353 1 671 9407
Author: Dr Andrew Rynne


Sir, - Ruaidhri Kirwan (November 1st) says there is a "considerable lack of
articles in the respected medical journals" supporting the efficiency of St
John's Wort. That is incorrect. There is in fact a wealth of published
material strongly supporting the efficiency and safety of hypericum. I
refer him to the British Medical Journal of August 3rd, 1996, page 253/258.
This is a meta-analysis of randomised clinical trials all clearly showing
the benefits of St John's Wort.

Mr Kirwan's second incorrect argument is that hypericum acts primarily as a
monoamine oxidase inhibitor (MAOI) and that this justifies the IMB
restricting it to doctors' prescriptions. The actions of St John's Wort on
the human brain are complex and not yet fully understood. No single
component accounts for all of its antidepressant action. Instead, several
synergistic effects are produced, some Prozac-like, some MAOI-like, though
the latter are thought to be the weaker.

Underlying this whole debate are profoundly serious implications for
citizens who value some freedom of choice in matters affecting their own
health. I think the following points deserve careful consideration:

1. St John's Wort is just the first naturally occurring product that the
Irish Medicines Board has singled out to become prescription only. All
other herbal, homeopathic and nutritional supplements are vulnerable to the
same restrictions since they are, by the IMB's definition, "medicinal
products". So where is this all going to end?

2. The IMB receives its funds not from the State but from product
authorisation and licence maintenance collected from the international
pharmaceutical industry. Thus it is not wholly independent. Clearing the
pitch of unlicensed contenders is very much in its own interest.

3. Placing herbal remedies on a doctors' prescriptions to be later subject
to a pharmacist's dispensing fee adds at least pounds 25 to a product with
an over-the-counter value of about pounds 10. Since most doctors know
little or nothing about herbal medicine or homeopathy, this additional fee
adds nothing to the value of their therapy.

4. Ireland is the only country in the world where St John's Wort is to be
the subject of a doctor's prescription alone.

5. It is estimated that some 20,000 people die each year in the United
States alone from the side-effects of single molecular licensed allopathic
pharmaceutical products. There is no reported mortality from homeopathic or
herbal remedies, used properly. Licensing authorities such as the IMB have
a poor track record when it comes to guarding our health.

6. Forcing natural products like St John's Wort on to prescriptions will
drive them "underground". This law will be unworkable and unpoliceable.
People who choose not to go to their GP for hypericum can always concoct a
version of it in their own kitchen, garnered from their own shrubbery. Is
this really what we want to happen?

- - Yours, etc.,

Dr Andrew Rynne, Downings House, Prosperous, Co Kildare.

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