St John's Wort May be an Effective Anti-depressant
suffering from severe depression could find St John's wort as effective a
treatment as prescribed drugs but with fewer side effects, a new study suggests.
The finding adds to existing evidence that extracts from the herb can be used
against mild and moderate depression.
The herb is
commercially available but the amount of the active compounds can vary greatly.
So to compare St John's wort to the widely-prescribed antidepressant paroxetine,
Meinhard Kieser and his colleagues from Dr Willmar Schwabe Pharmaceuticals in
Karlsruhe, Germany, used an extract of the herb.
assessed improvement during treatment using a standard scale called the Hamilton
depression scale. "Healthy people have a score lower than 10 on the scale, while
those with depression have a score of at least 14 and the severely depressed
around 24 or 25," explains Angelika Dienel, one of the team.
At the end of a
six week trial, hypericum decreased Hamilton depression scores by an average of
14, compared with a decrease of 11 among patients taking paroxetine, suggesting
that the St John's wort extract is at least as effective against severe
St. John's Wort
: No placebo
people for the study, 301 volunteers with a Hamilton depression score of at
least 22 took a placebo for up to seven days, and those that showed improvement
were excluded. It would be have been unethical to give severely depressed people
a placebo for the entire study - which lasted six weeks - so no placebo control
group was used.
251 patients were randomised to take either hypericum or paroxetine. After two
weeks the dose was doubled in people whose Hamilton scores did not decrease by
at least 20%.
As well as
similar improvements in their depression, the hypericum group also reported
fewer side effects than those on paroxetine. Just 55% of the group complained of
diarrhoea, nausea, dizziness, sweating or upper abdominal pain among others,
compared with 76% of the paroxetine group. But people who took the extract were
more likely to have upper abdominal pain: 10% compared with 7% of paroxetine
GlaxoSmithKline, which makes paroxetine, points out that a single study cannot
adequately assess safety, while paroxetine has 13 years of data behind it, and
has been through clinical studies involving 24,000 people.
studies in severely depressed people have failed to show that St John's wort has
any effect over that of placebo, so larger studies may be needed to confirm its
talk to their doctor before taking St John's wort in any form, because it can
interfere with other drugs, says Amelia Mustapha of the UK's Depression
Alliance. She says that despite earlier evidence of its use against mild
depression, there is still no licensed form of the herb.
prescribe it as they prescribe books or exercise but they don't feel comfortable
doing it because it isn't standardised," she says. "You can get St John's wort
teabags with little or no extract in them and how are people to know the
reference: British Medical Journal (DOI: 10.1136/bmj.38356.655266.82)
Feb. 11, 2005
NewScientist.com News Service
Licensed Psychologist Ph.D. Candidate
(Health and Geriatric Psychologist)
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