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St John's wort for depression.

K Linde1, C D Mulrow, M Berner

  • 1Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität München, Kaiserstr. 9, Munich, Germany, 80801. Klaus.Linde@lrz.tu-muenchen.de

The Cochrane Database of Systematic Reviews
|April 23, 2005
PubMed
Summary
This summary is machine-generated.

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St. John's wort (Hypericum perforatum) extracts show mixed results for depression. While some studies suggest benefits comparable to standard antidepressants, evidence remains inconsistent, particularly for major depression. Further research is needed.

Area of Science:

  • Pharmacology
  • Psychiatry
  • Evidence-based Medicine

Background:

  • Hypericum perforatum L. (St. John's wort) has a long history in folk medicine for treating depressive disorders.
  • Scientific investigation is needed to validate its efficacy and safety compared to conventional treatments.

Purpose of the Study:

  • To evaluate the effectiveness of St. John's wort extracts against placebo and standard antidepressants for adult depression.
  • To assess the safety profile of St. John's wort, specifically adverse effects compared to standard antidepressants.

Main Methods:

  • Systematic review of randomized, double-blind trials comparing St. John's wort with placebo or standard antidepressants.
  • Inclusion criteria focused on depressive disorders and clinical outcome measures like symptom scales.

Related Experiment Videos

  • Responder rate ratio and dropout rates due to adverse effects were key outcome measures.

    • Main Results:

    • 37 trials were analyzed, with 26 placebo comparisons and 14 comparisons against standard antidepressants.
    • Placebo-controlled trials showed heterogeneity; St. John's wort demonstrated potential benefits, especially in non-major depression.
    • Compared to SSRIs and tricyclic antidepressants, St. John's wort showed similar effectiveness with fewer dropouts due to adverse effects.

    Conclusions:

    • Evidence on St. John's wort for depression is inconsistent and requires careful interpretation.
    • Recent placebo-controlled trials suggest minimal benefits for major depression, while others indicate efficacy similar to standard antidepressants.
    • Pharmaceutical quality variations in St. John's wort products may explain inconsistent findings; results apply only to tested products.