Rhodiola better than Zoloft for treating depression

A few months ago the internet buzzed with the news that researchers at the University of Pennsylvania had found that the herb Rhodiola was a better antidepressant than the popular antidepressant Zoloft. The aim of this article is to investigate whether this was, in fact, the study’s conclusion, and to compare the antidepressant and side effects of these two remedies.

Zoloft is an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class. For the last few decades, it has been one of the most commonly prescribed drugs for depression, obsessive compulsive disorder, generalised anxiety disorder, posttraumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder. Rhodiola is a plant with a route that is believed to have medicinal properties. The natural health communities in numerous countries use it to increase physical stamina and strength, to shorten post-workout recovery, to treat depression, to improve memory, to improve sexual performance, and to treat irregular heartbeat and high cholesterol.

How Zoloft Works

When left alone, the neurotransmitter serotonin is naturally absorbed back into the nerve cells in the brain. When you take an SSRI, this absorption is prevented,  with the result that the serotonin remains in the gaps between the nerve cells (the synapse.) Scientists believe that the presence of serotonin between the nerve cells improves the communication between them, and that this can strengthen the circuits in the brain which regulate mood.

How Rhodiola Works

Rhodiola is believed to be an adaptogen. An adaptogen is a natural substance that increases the body’s general resistance to physical and emotional stress. Its effectiveness against depression seems to stem from its ability to increase the transport of tryptophan and 5-hydroxytryptophan into the brain. These substances are serotonin precursors, the same ones boosted by st John’s Wort. Moreover, animal studies discovered that rhodiola increased the cell proliferation, cell differentiation, and the number of neurons in the cerebral hippocampus of depressed and stressed rats, which seemed to increase brain function related to mood by repairing injured neurons in the hippocampus.

The Evidence for Zoloft’s Antidepressant Effects

Zoloft’s antidepressant effects are well documented, including for children and the elderly. The scientific findings are not all unanimous, however, and many of the latest studies, including those published by antidepressant manufacturers, show that antidepressants in general are not much better than placebos for many people, except in cases of severe depression where they do seem to outshine placebos.

The conflicting results have both researchers and drug companies confused, but the explanation may be quite simple. They seem to work for some depression sufferers while doing nothing for others, and at this stage scientists do not understand the characteristics of those for whom they work versus the characteristics of those for whom they do not work. This is unsatisfactory, for sure, but it is the best that science has gathered at this stage.

The Evidence for Rhodiola’s Antidepressant Effects

Before comparing the antidepressant effects of the two treatments, it is worth remembering that Zoloft has been according to some in anycase, much more thoroughly studied over a period of decades. While rhodiola is still quite scantily studied, but this in my opinion is because it is not in the financial interest of many researchers to do so, as it is near on impossible to patent a herb. And so the more scientists dig, the more likely they are to discover problems with previous studies for rhodiola. But then the same could be said for previous studies on Zoloft if we looked closely there too.

A 2007 article in the Nordic Journal of Psychiatry found that people who suffered from mild to moderate depression benefited from 340 or 680 mg of Rhodiola over a six week period. 31 of the study’s participants received two tablets of rhodiola extract daily (340 mg per day), 29 participants received two rhodiola tablets twice a day (680 mg per day), and 29 participants received two placebo tablets daily. The authors discovered that both groups that received rhodiola experienced an improvement in their depression, insomnia, emotional instability, and somatisation score, but not in their self-esteem score. The placebo group remained the same.

In the following year, University of California academics who tested rhodiola on 10 subjects with generalised anxiety disorder found that the symptoms of every one of them improved, while a study on rats concluded that 20 grams per body kilogram per day reduced their level of depression and increased their physical performance. They identified Rhodioloside and tyrosol as the active components of the root through which it had its antidepressant effects.

In a 2015 study that directly compared the effects of rhodiola and Zoloft, researchers at the University of Pennsylvania found that Zoloft had slightly stronger antidepressant effects than rhodiola, but that its side effects were much worse. Unlike the previous studies, their subjects had been diagnosed with mild to major depression, which perhaps explains why the participants who received Zoloft improved a bit more than those who received rhodiola. Still, while Zoloft worked better than rhodiola, rhodiola was not far behind. This is the study about which many bloggers became enthusiastic earlier this year, but as you will see if you read the study abstract, the study did not, in fact, find rhodiola to have greater antidepressant effects than Zoloft. The problem with Zoloft was simply that many participants were threatening to stop taking it because of its severe side effects.

The Side Effects of Zoloft

The side effects of Zoloft are numerous. They include drowsiness, insomnia, decreased sex drive, impotence, difficulty reaching orgasm, nervousness, headache, dizziness, nausea, constipation, diarrhoea, dry mouth, skin rash, an increase or decrease in appetite, and weight gain or loss. All consumers certainly do not experience all of the side effects, but the insomnia and sexual problems are almost universal. Zoloft does have fewer side effects than the older tricyclic-style antidepressants, but they are still difficult.

The Side Effects of Rhodiola

Rhodiola has very few side effects and they are relatively mild. They include increased blood pressure, slight blood thinning, dizziness, dry mouth, and in very few cases nervousness.

Where Possible, Try Treating Depression Naturally First

Those with mild to moderate depression should definitely try rhodiola first for both its antidepressant effects and its lack of serious side effects.

In the case of major depression, the choice is difficult. If Zoloft’s side effects outweigh its ability to effectively treat your depression, you are better off taking a slightly less effective antidepressant which does not have those side effects. If you can live with insomnia and sexual problems and some other side effects without it getting you down further, Zoloft is still the better antidepressant for major depression, for some people anyway.

If you have major depression and you are one of the unfortunate ones for whom Zoloft works no better than a placebo, you have no choice but to try taking rhodiola if there were only two options presented to you.

A last possibility to explore is the combination of a synthetic antidepressant and rhodiola. Interestingly, a non-peer reviewed study concluded in 1986 already that depression sufferers who took rhodiola with an antidepressant experienced a great reduction of depression symptoms and fewer side effects than those who used the antidepressant alone. While this study was not peer reviewed, never replicated, and tested on an antidepressant that was not Zoloft, those with major depression may ask their physicians about the possibility of enhancing an antidepressant with rhodiola.