Sunday, August 25, 2019

Antidepressant Herbs: St. John’s Wort?


Antidepressant Herb Hypericum Perforatum Tested Against Placebo, Maprotiline And In More Than 3250 Patients In Germany

St. John’s Wort or Hypericum perforatum related several studies are available that are of high quality, double blind, placebo controlled and done in multiple centers.

One multicenter based study found hypericum extract to have comparable effect with standard drug Maprotiline. Hypericum extract has slower onset of action while Maprotiline has faster onset of action.

Another double blind placebo controlled observation group study concluded with the recommendation of hypericum extract as antidepressant botanical for mild to moderate depressant outpatients.

Researchers concluded in this double blind placebo controlled study that hypericum extract treatment showed good patient compliance, lesser side effects and no drug interactions in this trial as compared to standard pharmacological drug for depression.

In this interesting study, 3250 patients chosen from practices of 663 doctors were evaluated on D-S scores. The conclusion has been similar to former studies – lesser dropouts, better acceptance, effective, lower profile of side effects and adverse effects.

A Multicenter Based Study Comparing St. John’s Wort With Maprotiline (1994):

102 patients of depression with one moderately severe episode of depression were taken into this randomized double blind study. They received indistinguishable tablets of st. john’s wort in the dose of 0.9 mg hypericin thrice a day or maprotiline 25 mg thrice a day for four weeks.

The benefits of both regime were comparable on HAMD, CGI and D-S scores. Whereas Maprotiline had been fast acting and hypericum. St. John’s Wort is especially noted for its mild side effects.

Au:Harrer-G, Huebner-D, Podzuweit-H

So: J Geriatr Psychiatry Neurol 1994: 7(suppl 1): S24-28

Multicenter Double Blind Study Finding The Effectiveness Of St. John’s Wort (1994):

This study was done on 72 major depression patients (according to DSM-3-R; HAMD score 16 or more) from 11 psychiatry clinics. The patients were given placebo or st. john’s wort (0.9 mg total hypericin) for six weeks.

To make it an observation group study, the placebo group was also given st. john’s wort extract in last two weeks therefore all the persons received hypericin in last two weeks.

The results demonstrated that there was improvement in placebo group in 5th and 6th week while there was continuous improvement in trial group. Results were supported by HAMD responder rate, D-S scale, CGI score and BEB.

Only three patients reported mild side effects – one case of sleep disturbance in hypericum group and two cases of gastrointestinal disturbance in placebo group.

This trial was of great value since the influence of doctor’s had been eliminated in it. Researchers concluded that hypericum extract can be recommended with as an antidepressant for outpatients.

Au: Hänsgen-K-D, Vesper-J and Ploch-M

SO: J Geriatr Psychiatry Neurol 1994; (supl1) PP 15-18

St. John’s Wort And Mild To Moderate Depression (1994):

105 patients of Neurotic Depression and brief depressive reaction were taken into a double blind clinical study. Patients were given either hypericum extract (0.9 mg hypericin) thrice a day or a similar placebo the same times a day.

Out of 105 patients, only 89 patients were there unto the end of the study. There had been record of all other treatments for getting info about possible interactions.

67% of patients responded to hypericum extract and 28% responded to placebo treatment. The mean HAMD score as well as associated symptoms show improvement in hypericum group.

Two patients in hypericum group showed adverse effects in the form of fatigue and skin rashes while three patients reported side effects in placebo group like confusion, restlessness of mind, weight gain, edema, insomnia and abdominal upset. This might result due to psychosomatic symptoms in the placebo group.

Researchers concluded that there had been good patient compliance with hypericum extract as compared to pharmacological drugs with less side effects and no drug interactions in this study.

AU: Sommer-H; Harrer-G

AD: Psychiatrische Fachpraxis, Universitat Salzburg, Austria.

SO: Phytomedicine Vol. 1/1994, pp 3-8

Benefits And Risk Of St. John’s Wort Extract With Drug Monitoring Study in 3250 Patients (1994):

Based on the von Zerssen’s D-S self-rating scale, 3250 patients were taken from 663 private practitioners for investigating the effectiveness and acceptance of st. john’s wort extract over a four week duration.

According to final results rendered by both the doctors as well as patients, 80% of the patients felt better with st. john’s wort whereas only 15% of patients felt unchanged or worsened. 

Response rate was between 60 to 70% on D-S scale. The side effects had been mild and comparable in both the st. john’s group as well as placebo group. Side effects have been rare only in 2.4% (as compared to 19% in a similar sized study of Fluoxethine) of patients and only 1.45% (five times lower than studies with drugs) patients dropped out of treatment.

Researchers commented that side effects had been comparable in trial and placebo groups because the common symptoms like gastrointestinal upset, anxiety, fatigue and dizziness were already present in many patients so it could not be said that side effects might have been due to st. john’s wort treatment.

The reactions that has been seen in 0.5% patients was not related with photosensitizing effect of st. john’s wort so their nature was like drug reactions.

Researchers concluded that st. john’s wort extract has good antidepressant effect with relatively better acceptance, lesser dropouts and significantly lower profile of side effects and adverse reactions than modern pharmacological drugs.

AU: Woelk-H; Burkard-G; Grunwald-J

AD: Psychiatrisches Landeskrankenhaus und Akademisches Lehrkrankenhaus, Universitat Giessen, Germany.

SO: J-Geriatr-Psychiatry-Neurol. 1994 Oct; 7 Suppl 1: S34-8

As a native Indian and an Ayurvedic holistic healer, Arjun writes in the lane of herbal healing and home remedies. Certification: BAMS (Bachelor of Ayurvedic Medicine & Surgery With Modern Medicine).

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