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Anti-Depressant Effects of Salvia
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ARTICLE |
Antidepressant Effects of the Herb Salvia Divinorum:
A Case Report
Karl R. Hanes,
PhD
Journal of Clinical Psychopharmacology
2001;21:634-635
Editors:
Case Report
Ms. G is a 26-year-old woman with a history of depression
that has shown no significant periods of remission since adolescence and
has been predominated by feelings of worthlessness, lack of interest in
social activities, an absence of occupational satisfaction, and inability
to find “purpose and meaning” in her life. After first seeking treatment
for her depression 5 years ago Ms. G was prescribed sertraline, 50 mg
daily, which she self-discontinued after 3 months, reporting no
significant benefits. Ms. G then underwent a course of
cognitive-behavioural therapy for about 6 months, with some improvement
but no definitive resolution of her symptoms. Hamilton Depression Rating
Scale (HAM-D 1
) scores during the 6-month period of cognitive-behavioural therapy were
consistently in the moderately depressed range (i.e. 19–21).
During a review consultation some 7 months after discontinuing
cognitive-behavioural therapy Ms. G claimed to have found relief from her
symptoms of depression with use of the herb salvia divinorum sourced
through a mail-order herbal supplier. A HAM-D score of 2 confirmed
remission of her symptoms of depression at this time. Ms. G claims that
she discovered its antidepressant effects accidentally after smoking the
herb and had later developed a method of oral consumption which she
claimed maintained its antidepressant effects even after she abstained
from using it for up to a week.
Despite being cautioned against
use of a herb whose safety profile was unknown, she has continued to use a
preparation of salvia divinorum leaves taken as an oral dose of 2–3 leaves
(1/2 to 3/4 of a gram of leaf material) three times per week (the leaves
are chewed and held in the mouth for 15–30 minutes). During this period
she has continued to show a total remission of her symptoms of depression
according to HAM-D scores in the range of 0–2 and has maintained this
improvement for the last 6 months, showing no signs of relapse and
reporting only minimal side effects, such as occasional lightheadedness
for up to 1 hour after using the herb.
Ms. G volunteered that she
has also benefited from occasional intoxicating oral doses of salvia
divinorum, consisting of from 8–16 leaves of the herb (approximately 2 to
4 grams), claiming that this herb had engendered a kind of
“psychospiritual” awakening, characterized by the discovery of the depth
of her sense of self, greater self-confidence, increased feelings of
intuitive wisdom and “connectedness to nature.”
Discussion
Salvia divinorum is a perennial herb of
the Labiateae (mint) family native to the Sierra Mazateca region of
Oaxaca, Mexico. 2–4
Its main constituents have been identified as the neoclerodane diterpenes
Salvinorin A and B 5,6
while trace elements of several other diterpenes have also been detected.
6
The plant has been used in healing ceremonies by the Mazatec Indians of
Oaxaca for centuries and for the treatment of such conditions as anaemia,
headache, and rheumatism. 7
The psychoactive effects of the main ingredient Salvinorin A in humans
were uncovered recently and it has enjoyed some popularity since that time
as a legal, short-acting psychedelic, though its psychoactivity varies
considerably depending on dosage and method of ingestion. 8
This
unique case may be of interest to the psychiatric and
psychopharmacological communities in demonstrating the possible
therapeutic effects of the unique active components of salvia divinorum in
a case of treatmentresistant depression. While the typical dose used by
this patient in maintenance management of her depression, consisting of
2–3 leaves, is well below that reported to cause significant intoxication
when taken orally, 8
one cannot discount the possibility that some of the benefits derived from
salvia divinorum were due to the psychedelic qualities associated with the
larger doses of this herb used occasionally by this patient.
While
a discussion of these effects is outside the scope of this paper, the
value of psychedelic compounds as research tools and their beneficial
effects in the amelioration of symptoms of psychiatric conditions is well
established. 9–11
Given that the mechanisms of action of the constituents of salvia
divinorum remain unknown and the spectrum of psychedelic effects of this
herb appears to be unique, 8
it is not inconceivable that research using the active ingredients from
this herb may pinpoint a unique mechanism of antidepressant action for
these compounds. This, in turn, could lead to methods for the management
of depression or of treatment-resistant subtypes of this condition. This
possibility is further enhanced by the recent finding using the screening
procedure called Novascreen that Salvinorin A did not show significant
inhibition of reference target compounds on any of the 42 known
bioreceptors tested. 8
We may be dealing with a highly novel agent that has significant research
and therapeutic potential in fields such as psychopharmacology, psychiatry
and complementary disciplines such as herbal medicine.
Karl R.
Hanes, PhD
Cognitive-Behavioural Treatment Centre, Melbourne,
Victoria, Australia
References
- Hamilton M. A rating scale for depression. Journal of Neurology,
Neurosurgery and Psychiatry, 1960; 23: 56– 62.
- Johnson JB. The elements of Mazatec witchcraft. Goteborg
Ethnografiska Museum. Ethnologiska Studier 1939; 9: 119– 149.
- Wasson RG. A new Mexican psychotropic drug from the mint family.
Botanical Museum Leaflets. Cambridge, MA: Harvard University 1962; 20:
77– 84.
- Epling C, Jativa M. A new species of salvia from Mexico. Botanical
Museum Leaflets. Cambridge, MA: Harvard University 1962; 20: 75– 76.
- Ortega A, Blount JF, Manchand PS. Salvinorin, a new
transneoclerodane diterpene from salvia divinorum (Labiatae). Journal of
the Chemical Society, Perkin Transactions 1:Organic and Bio-Organic
Chemistry, 1982;2505–2508.
- Valdes III, JL Butler WM, Hatfield GM, Paul AG, Koreeda M. Divinorin
A, a psychotropic terpenoid and divinorin B from the hallucinogenic mint
Salvia divinorum. Journal of Organic Chemistry, 1984; 49: 4716– 4720.
- Valdes III, JL Diaz JL, Paul AG. Ethnopharmacology of Ska Maria
Pastora (Salvia divinorum Epling and Jativa-M). Journal of
Ethnopharmacology, 1983; 7: 287– 312.
- Siebert DJ. Salvia divinorum and Salvinorin A: new pharmacologic
findings. Journal of Ethnopharmacology, 1994; 43: 53– 56.
- Riedlinger TJ, Riedlinger JE. Psychedelic and entactogenic drugs in
the treatment of depression. Journal of Psychoactive Drugs, 1994; 26:
41– 55.
- Henrietta LL, Rapoport JL. Relief of obsessive-compulsive symptoms
by LSD and psilocybin. American Journal of Psychiatry, 1987; 144: 1239–
1240.
- Strassman RJ. Hallucinogenic drugs in psychiatric research and
treatment: perspective and prospects. The Journal of Nervous and Mental
Disease, 1995; 183: 127– 138.
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RESOURCES |
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Specific to Salvia divinorum (Diviner's Sage):
Additional
information:
Relevant
organizations:
The Drug Policy Alliance
- Alternatives to the war on drugs based on
science, compassion, and human rights.
The Center for Cognitive Liberty
& Ethics (CCLE). Working
in the public interest to foster freedom of thought.
MAPS (The Multidisciplinary Association
for Psychedelic Studies). Supporting psychedelic research since 1986.
The Council on Spiritual Practices.
Making direct experience of the sacred more available to more
people.
The Media Awareness Project. A
worldwide network dedicated to drug policy reform.
The Drug Reform
Coordination Network. A national network of more than 21,000 activists
and concerned citizens including parents, educators, students, lawyers,
health care professionals, academics, and others working for drug policy
reform. DRCNet supports rational policies consistent with the principles
of peace, justice, freedom, compassion and truth. Each of these has been
compromised in the name of the Drug War.
Students
for Sensible Drug Policy. Students for Sensible Drug Policy is
committed to providing education on harms caused by the War on Drugs
working to involve youth in the political process, and promoting an open,
honest, and rational discussion of alternative solutions to our nation's
drug problems.
The
American Civil Liberties Union. Useful drug policy links.
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