[High dose St. John's wort extract as a phytogenic antidepressant]

Area of Science:

• Phytochemistry and Pharmacology
• Clinical Medicine
• Evidence-Based Practice

Context:

• Hypericum extract (St. John's Wort) has a history of traditional use for depression.
• Standardized extracts have been approved in Austria and Germany since 1998.
• Clinical trials have substantiated its efficacy since 1984.

Purpose:

• To review the efficacy and safety of standardized hypericum extract for depression.
• To compare hypericum extract with placebo and synthetic antidepressants.
• To elucidate the pharmacological mechanisms and optimal dosage.

Summary:

• Twenty controlled clinical trials involving 1,787 patients were analyzed.
• Effective dosage ranges from 600 to 900 mg of extract.
• Side effects are infrequent (around 3%), with photosensitization being the primary concern at recommended doses.
• Pharmacological studies suggest a mechanism similar to selective serotonin reuptake inhibitors (SSRIs).

Impact:

• Hypericum extract offers a viable alternative for treating mild to moderate depression.
• Its favorable side effect profile makes it a potentially safer option compared to synthetic antidepressants.
• Further research into its precise mechanism of action may refine its therapeutic application.