It is important to remember that there have been no head-to-head trials comparing St John’s Wort with the SSRIs in the treatment of depression. All reports of comparisons between the herbal and synthetic anti-depressants are therefore anecdotal. Nevertheless, there are lessons to be learned from anecdotes and one conclusion I have reached, based on many stories that there are certain people who do better on St John’s Wort than on the SSRIs. When both types of antidepressants are used in their conventional dosages, St John’s Wort appears to be superior to the SSRIs with respect to side-effects. Particularly, it appears to cause fewer sexual side-effects, less weight gain and fewer feelings of dullness in thinking or feeling. When used in their conventional dosages it is possible that the SSRIs may be more potent and I have encountered cases where they have reversed depressive symptoms that did not respond to St John’s Wort alone. In the currently planned multi-centre research study sponsored by the US National Institute of Mental Health, St John’s Wort and the SSRI Lustral are to be compared for the first time; It will be fascinating to see how they stack up against each other. In the meanwhile each depressed person will have to choose the type of anti-depressant – herbal or synthetic -best suited to his or her needs based on the information available and his or her own personal preferences.