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Effect of St. John's wort extract on depressive disorder in elderly patients with unstable angina
Jian Liu1, Zhao-Wei Meng1, Li-Yu Li1
1Department of Emergency Medicine, the Second Hospital, Tianjin Medical University, Tianjin 300211, China.
Insights
St. John's wort extract (SWE) significantly improved depression and angina in elderly patients with unstable angina pectoris. SWE demonstrated superior efficacy compared to Deanxit and psychotherapy, offering a promising treatment option.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Elderly patients with coronary heart disease (CHD) frequently experience comorbid depression.
- Unstable angina pectoris is a common condition in this demographic, often accompanied by depressive symptoms.
Purpose of the Study:
- To evaluate the efficacy of St. John's wort extract (SWE) in treating depressive disorder among elderly patients diagnosed with unstable angina pectoris.
- To compare the effectiveness of SWE against Deanxit and psychotherapy in this patient population.
Main Methods:
- A prospective study involving 170 elderly patients meeting specific criteria.
- Randomized allocation into four groups: SWE, Deanxit, psychotherapy, and a control group.
- Assessment of treatment effectiveness based on reduced Hamilton Depression Rating Scale (HAMD) scores and decreased frequency of angina pectoris attacks over 12 weeks.
Main Results:
- St. John's wort extract (SWE) group showed a 79.5% reduction in HAMD scores, significantly greater than Deanxit (56.8%) and psychotherapy (57.1%) groups (P<0.05).
- Significant improvements in angina pectoris, as assessed by the Canadian Cardiac Society Classification, were observed in all treatment groups compared to the control, with the SWE group showing the most marked improvement (88.7%, P<0.001).
- Frequencies, durations of angina attacks, and electrocardiographic changes were significantly improved in the SWE group compared to controls (P<0.05).
Conclusions:
- St. John's wort extract (SWE) is more effective in improving depressive symptoms in elderly patients with unstable angina pectoris than Deanxit or psychotherapy.
- SWE also demonstrates a significant positive impact on the treatment of angina attacks in this patient cohort.
Background:
The elderly patients with coronary heart disease (CHD) are often accompanied with depression. This study aimed to assess the effect of St. John's wort extract (SWE) on depressive disorder in elderly patients with unstable angina pectoris.
Methods:
Altogether 170 patients who met the set criteria were enrolled in this prospective study. They were randomly divided into SWE group (44 patients), Deanxit group (44), psychotherapy group (42), and control group (40). The effectiveness of SWE was evaluated by reduced percentage of Hamilton depression (HAMD) scale and reduced frequency of angina pectoris attack, which were measured before and at 12 weeks after the treatment with SWE.
Results:
The reduced percentages of HAMD scale were 79.5%, 56.8% and 57.1% in the SWE, Deanxit and psychotherapy groups, respectively. Compared with the control, the three groups had significant differences in the percentages (P<0.001). The improvement after the treatment was more significant in the SWE group than in the Deanxit or psychotherapy group (P<0.05). The improvement of angina pectoris evaluated by the Canadian Cardiac Society Classification was significantly better in the treatment groups (88. 7%, 65. 9%, 57.1%) than in the control group, and it was marked in the SWE group (P<0.001). Angina pectoris attack, its frequencies, durations and electrocardiographic changes were significantly improved in the treatment groups than in the control group (F=6.05, 4.58, 5.12, P<0.01). They are markedly improved in the SWE group (P<0.05).
Conclusion:
SWE can improve depressive symptoms more significantly in elderly patients with unstable angina pectoris than Deanxit or psychotherapy, proving that SWE contributes to better treatment of angina attack as well.
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