Cimicifuga: Cimicifuga for depression

by Deborah Frances, ND

Medical Herbalism 7(1-2):1,10-11

A few years ago while doing some research for a homeopathic case, I came across the following symptoms for Cimicifuga racemosa (Black Cohosh) in Beoricke’s Materia Medica: “Sensation of a cloud enveloping her. Great depression, with dream of impending evil.”

I began to wonder, could this be another medicine to add to our herbal pharmacy for the treatment of depression? Many of its other homeopathic indications parallel its herbal use in pelvic disease and musculoskeletal spasm. Perhaps it could be used in crude doses for depression as well. Another homeopath, Phatek, writes this about Cimicifuga: “Melancholy,...irritable...gloomy. Indifferent. Despondent, seems to feel under a heavy black cloud...sits and mopes in great sadness.”

Herbalist and homeopath Matthew Wood writes in his book Seven Herbs: Plants as Teachers, “Black cohosh is a remedy for those who are caught in a state of brooding, dark hopelessness.” “The mental state is one of the darkest found in any remedy.” “The dark mood of Cimicifuga is usually worse before the period.” “Stimes the Black Cohosh patient has been through so much, has seen such a dark side of life so dearly, that he or she will not speak freely...not thinking anyone will believe how devastating is the extent of abuse they have been subjected to.”

Subsequent research and experience have led me to think of Cimicifuga for a deeper, darker depression than Hypericum perforatum — St Johnswort — or in cases when there is a history of sexual abuse, alcoholism, or drug abuse. I find it is well indicated when the depression is associated with complaints of spaciness or difficulty concentrating and I sometimes give it for this symptoms alone, even when symptoms of depression are not present. Of course Cimicifuga comes quickly to mind for depression in cases where physical symptoms are centered around pelvic organs or hormonal imbalances.

Case #1

A 43 year-old woman reported the following problems: constant abdominal pain of two years duration, across the lower abdomen and suprapubic areas. Pain would get quite severe in the two days prior to menses. She described it as a “deep ache with throbbing.” Her menses had changed at the time of the onset of pain with more frequent periods, sometimes two weeks apart and spotting at midcycle after coition. She reported having had a tubal ligation three years previous. Medical workup including laparotomy was negative.

“I’m very depressed,” she stated. “I have a lot of stress and anxiety and I tend to drink alcohol at these times.” “I can’t focus, I flip from one thing to another. I’m too easily distracted. I feel such guilt for being so dysfunctional. I feel totally helpless and hopeless. why get out of bed? There is nothing to look forward to. The despair is overwhelming.”

I gave her Cimicifuga in tincture 30 drops three times a day along with the indicated homeopathic medicine which was Medorrhinum. On return visit one month later she reported great improvement of all symptoms. Abdominal pain was gone, the spotting had ceased, and it had been 3 1/2 weeks since her last period. She reported that her depression was significantly better until stopping the Cimicifuga, which she had run out of two weeks earlier and not refilled. She also said her energy was better on the tincture and was wanting it again since she had discontinued it. She stated that she felt less flighty and “wild” in her mind while on the herb but that these symptoms had also recurred when she ran out. She had taken Prozac in the past and she felt the Cimicifuga worked better. The herbal tincture was restarted with dose results and she now takes Cimicifuga periodically as she feels she needs it.

Case #2

A woman first seen for cervical dysplasia ported that she struggled with episodes of depression, in which a black mood would seem to descend on her out of nowhere and last for a few hours to days. During these times she was more irritable and weepy and would struggle with a terrible despair and sense of doom. In addition to her regular herbal formulas, one of which included some cimicifuga, I suggested she take an additional 30 drops of Cimicifuga on those particular days, up to every two hours if needed. She reported that this made an enormous difference for her, often within one or two doses.

Case #3

A fifty year-old woman, with no physical symptoms of particular note, complained of depression and difficulty concentrating at work, since a neighbor had cut down several old trees near her home some days earlier. “The grief is overwhelming,” she said, crying as she spoke. “I can’t get out from under it. No matter how much we do to help the planet, there are still too many people who just don’t care. It’s too dark and hopeless. I can’t believe people have the power to do these things.”

Prescription: 30 drops Cimicifuga three or four times a day.

Two days later the patient called to report that she was much better. “The depression is gone!” she said. “I still feel grief at the loss of those beautiful trees, but I’m not overwhelmed by the feelings anymore and I’m more able to focus on my work again. That herb you gave me is amazing!”


Boericke, Wm. Materia Medica with Repertory. Boericke and Tafel. Sana Rosa CA. 1927.

Phatak, SR. Materia Medica of Homeopathic Medicines. Indian Books and Periodicals Syndicate. New Delhi. 1977.

Wood, M. Seven Herbs, Plants as Teachers North Atlantic Books. Berkeley. 1986


Dr. Frances article and cases demonstrate, among other things, the value of studying the homeopathic literature on botanicals. Many of the classical homeopaths used tinctures in their practices, and many of the indications in homeopathic books apply as well to lower doses of tinctures. In fact, thirty drops of a tincture might be viewed as the upper range of a homeopathic dose. Black Cohosh is still recognized today by homeopaths as a major remedy for depression (Murphy).

At the intersection of homeopathy and medical herbalism is the study of specific medication, with the idea of finding the best single remedy overall for a condition, taking into account not only the disease condition, but the specific symptoms, including the mental picture. The idea, as in homeopathy, is to hit the nail on the head and find just the right herb. Remarkable results can be obtained with lower doses if the right herb is found. This system of herbalism requires broad knowledge of the details of the herbal remedies, and also detailed knowledge of the mental symptoms of the patient.

Black cohosh, sometimes called Macrotys by Eclectic writers, was recognized by them as an herb with a strong affinity for the nervous system and for emotional conditions. Priest and Priest, British exponents of specific medication, call black cohosh a “cerebrospinal trophorestorative.” F. Harper-Shove, in his classic repertory of specific medication, lists black cohosh under “Hypochondriasis,” “Mania: despondency, all things seem black...believes going mad, tries to injure herself,” and also under “Melancholia: disorders with melancholy and weakness (spasmodic from menstrual troubles).”


Harper-Shove, F. Homeopathy Prescriber and Clinical Repertor of Medicinal Herbs

F. Harper-Shove. Jain Publishers. New Delhi. 1938

Priest AW, Priest LR. Herbal Medication: A Clinical and Dispensary Handbook L.N. Fowler and co. London. 1982

Murphy, R. Homeopathic Medical Repertory: A Modern Alphabetical Repertory Hahnemann Academy of North America. Pagosa Springs, CO. 1993.,
  Copyright 2001 Paul Bergner

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