Benefit Of St. John’s Wort Or Hypericum Perforatum On Stress, Sleep And Depression
Four clinical research studies about st. john’s wort are discussed here. They are about the benefit of hypericum extract on stress, sleep and depression.
First study has found increased melatonin secretion at night and suggests insomnia relieving activity in hypericum extract. The cortisol level has gone down on stress provoking tests and this indicates better tolerance of stressful conditions with hypericum extract therapy.
Second study found antidepressant effect of hypericum extract showed its full effect after four weeks of treatment. So hypericum therapy should not be considered for short term or immediate benefit.
Third study tested the effect of hypericum extract against standard drug Amitryptiline. The comparable antidepressant effect and lower side effects profile of st johns extract was found in comparable with Amitryptiline.
Fourth study of hypericum extract fulfilled one of the highest quality on Ernst Criteria. Hypericum extract was found comparable in its antidepressant effect with Imipramine and better in tolerance.
Effect On Melatonin And Cortisol Secretions By St. John’s Wort (1991):
The effect of st. john’s wort on nocturnal melatonin and cortisol secretion was measured in 12 persons. They were also given either 3000 lux (bright) or 300 lux (dim) of light therapy along with hypericum extract.
Light therapy with bright light was effective and dim light was ineffective previous to administration of hypericum extract. After hypericum administration, light therapy with dim light also became effective.
The secretion of melatonin at night increased after hypericum therapy. After three weeks of this regimen, nocturnal stimulation tests were done by awakening and sitting and these resulted in lesser increase in plasma cortisol suggesting that stress susceptiblity has gone down with hypericum therapy.
So administration of st. john’s wort is associated with increase of melatonin secretion at night and decrease of cortisol level.
AU:Demisch-L, Nispel-J, Sielaff-T, Gebhart-P, Köhler-C, Pflug-B
SO:Abstract from the AGNP-symposium, Nuernberg 1991.
St. John’s Wort Extract As An Effective Alternative Treatment For Depression 1992
50 patients of neurotic depression with brief depressive reaction were taken into this study. They were either two capsules of Neuroplant (2.5 mg of hypericin) twice a day or a similar placebo.
The inclusion criteria in this study was based on Hamilton Depression scale (HAMD), the Hamilton Anxiety scale (HAMA), the Clinical Global impression scale (CGI) and the von Zerssen self-rating scale (D-S).
80% of the patients responded from the hypericin group while only 44% responded from placebo group. Results were supported by HAMD, HAMA, CGI and D-S score.
Researchers found that most of the effect of st. john’s wort was noticed between fourth and eighth week of this 8 week study. This suggests that hypericum is effective against depression after a few weeks and there is need for long term study.
Au: Reh C, Laux P, Schenk N. :
So: Therapiewoche 1992; 42:1576-81
St. John’s Wort And Amitryptiline In Mild To Moderate Depression (1993):
80 patients were taken in this randomized double blind study for six weeks where hypericum perforatum was compared with Amitryptiline. Amitryptiline is a standard pharmacological drug used to treat depression.
In this study, Amitryptiline is given in the dosage of 10 mg thrice a day and st. john’s wort was given in capsule form in the dose of 0.25mg of hypericin three times a day.
The results of this study is supported by HAMD score, Bf-s and clinical data. Sleep is found to be improved and dreams had been more comfortable.
58% of people treated with Amitryptiline complained of side effects like tiredness, dry mouth and pressure in stomach with some gastrointestinal and respiratory symptoms. 24% of hypericum treated patients had side effects like gastric pain, tiredness and pressure in stomach.
This study concluded that hypericum is equally effective in comparison with amitryptiline for mild to moderate depression and possesses lower spectrum of side effects.
AU: Bergmann-R, Nuessner-J, Demling-J
SO: Neurologie/Psychiatrie 7, 235-240, vol 4 April 1993
Effectiveness And Tolerance Of St. John’s Wort Extract With Imipramine:1994
In this double blind study with 135 patients, hypericum extract was given in the dose of 0.9 mg hypericin thrice a day and imipramine was given 75 mg thrice a day.
The patients were analyzed on HAMD, D-S and CGI scores. This study demonstrated superiority of st. john’s wort extract over imipramine for fewer side effects and better patient tolerance.
This study was scored highest for quality by Ernst in criteria based review of hypericum studies (74 out of 110).
AU: Vorbach-EU; Hubner-WD; Arnoldt-KH
AD: Psychiatrische Klinik im Elisabethenstift, Darmstadt, Germany.
SO: J-Geriatr-Psychiatry-Neurol. 1994 Oct; 7 Suppl 1: S19-23