Parents and young patients may balk at the suggestion of treating depression with conventional medications. Yet, many self-administer alternative medicines despite a lack of research about their safety and efficacy. The present study examined an increasingly common alternative medicine used to treat depression: St. John’s wort. Thirty-three youths between the ages of 6 and 16 who met DSM-IV criteria for major depressive disorder with depressive symptoms of at least moderate severity participated in the 8-week outpatient study. Patients began with a prescribed 150mg of St. John’s wort three times daily. After 4 weeks, patients were evaluated and their dose was increased to 300mg three times daily if they did not meet a priori response criteria. Results revealed that after 4 weeks in the study, 22 patients had their St. John’s wort dosage increased to 900mg daily. After 8 weeks in the study, 25 of the 33 patients met a priori response criteria. In terms of safety, overall results indicated that St. John’s wort was well tolerated by patients. The authors conclude that St. John’s wort may be an effective treatment for youths with major depressive disorder. Placebo studies are indicated.