Sunday, June 16, 2019

St. John’s Wort for Depression

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St. John’s Wort Or Hypericum Perforatum Supported By Clinical Research Trials

The medicinal herb st. john’s wort or Hypericum perforatum has been extensively studied for its antidepressant effect. These studies have been presented here in a format that is an easy to read and understand.

Find how these studies with hypericum extract had been done with standard criteria of their own times like HAMD, CGI, D-S scores. And certainly the large proportion of these clinical trials were done in Germany where this herbal remedy has the reputation of being a prescribed herb by doctors.

Get familiar with the overall benefits of st. john’s wort as compared to modern pharmacological drugs. How various studies has validated its lower side effects, better compliance, equivalent effect and cheaper profile than conventional drugs.

The two clinical studies about hypericum are given here – one is perhaps the oldest and with more historical interest and second one is available with another botanical Valerian.

St. John’s Wort And Clinical Research Supported Benefits:

Hypericum is used in herbal medicine chiefly for depression and anxiety disorders. Three meta-analysis of clinical studies were done over a period of several years and they included more stern inclusion criteria. These meta-analysis proved efficacy of st. john’s wort comparable to modern pharmacological drugs and with a mild profile of side effects. Hypericum was found to be effective for mild to moderate depression with a score of 17 on HAMD score.

Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D (1996). St John’s wort for depression – an overview and meta-analysis of randomised clinical trials. Br Med J 313, 253–258.

Kim HL, Streltzer J, Goebert D (1999). st. john’s wort for Depression: A Meta-Analysis of Well-Defined Clinical Trials. J Ment Nerv Dis 187 (9), 532-538.

Linde K, Mulrow CD (2003). St John’s wort for depression (Cochrane Review). In: The Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd.

C. Randløv, J. Mehlsen, C.F. Thomsen, C. Hedman, H. von Fircks and K. Winther. “The efficacy of st. john’s wort in patients with minor depressive symptoms or dysthymia – a double-blind placebo-controlled study” Phytomedicine. 2006 March;13(4):215-221

St. John’s Wort And Depression

St. john’s wort is the most extensively studied and researched plant for depression. The overall benefit is outstanding for a botanical. 50-80% of depression patients found themselves with reduced symptoms and increased well-being after treatment st. john’s wort with.

This success rate is comparable with prescription drugs for depression. This success is complimented by fewer side effects, lower costs and availability as over the counter supplement. Sixteen prominent studies compared st. john’s wort to placebo and nine other studies compared it to mainstream antidepressants.

In most of these studies, both depression symptoms (depressed mood, anxiety, loss of interest, feelings of worthlessness, decreased activity) and secondary symptoms (sleep disturbance, lack of concentration, somatic complaints) improved significantly.

These compounded benefits with ongoing research, long history of use and its being prescribed in Europe, might open a future when st. john’s wort could be a first line herbal supplements.

More than 20 million people in Germany are taking Hypericum with regularity. More than 2000 people had been involved in double blind clinical research trial with this botanical out of a total of more than 5000 people.

Clinical studies had been widely done in past two decades in Europe and recently in United States about the the efficacy of st. john’s wort. Hypericum extract had been found to be better than placebo and equally effective as tricyclic antidepressants (TCAs) in the treatment of mild to moderate severe depression.

Studies comparing st. john’s wort with SSRIs(Serotonin Reuptake Inhibitors) like Fluoxetine and Sertraline are very limited. However it could be at par with these modern antidepressant drugs.

Perhaps The Oldest Study Of Antidepressant Effect Of St. John’s Wort (1979):

This study of more historical interest was done on 60 patients with mild, moderate and severe depression. Trial group was given 3 mg of hypericin thrice a day and others a placebo for six weeks.

The response rate was found 34.1% after three weeks and 61.4% percent after six weeks in trial group. Placebo group demonstrated 10.9% response after three weeks and 15.8% after six weeks.

This historical study is perhaps the oldest one and it lacks statistical analysis. And even DSM-3 scale and modern classification of depression were not available then.

Au: Hoffman-J, Kuehl-E-D

So: Z allg. Med. 55, 776-782(1979)

Depressive Moods With St. John’s Wort And Valerian (1985):

This study compared hypericum and valerian with antidepressant drug desipramine on 93 patients. This study reported far greater efficacy of the herbal combination over the drug desipramine.

This study included three types of scoring system – CGI and Bf-B for measuring physical complaints and D-S score for psychic criteria.

There was no significant difference in side effects between the two groups. Side effects were mild like dry mouth, tiredness, vertigo and tachycardia.

Authors concluded that despite using very low dose of hypericum in this study (0.2 mg daily dose of hypericin against 0.9-2.7 mg daily dose), the herbal combination was found with better efficacy, faster effect and better tolerance than antidepressant drug desipramine.

This kind of results are unusual with herbs or herbal combinations. It was suggested that further studies should be done comparing valerian, hypericum and their combination with placebo and drugs.

Au: Steger-W

So: Z. Allg. Med. 1985: vol61 pp 914-918

Arjun
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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