St John’s wort for depression: meta-analysis of randomized controlled trials.
Extracts of St. John’s Wort have been used to treat depression. Whether or not it is effective has been questioned by those in the medical field. Reviews published between 1996 and 2000 have concluded that such extracts are more effective than placebo and can be compared to previous antidepressants in the treatment of mild to moderate depression. Some of these reviews were criticized because patients did not meet the criteria for major depression, and were conducted by physicians that were not experienced in depression diagnoses.
In this case they searched both English and non-English language for those both published and unpublished trials, the last search being in July of 2003. Their inclusion criteria were as follows; a double-blind, randomized, controlled trial study design. Participants were adult patients that were treated for depressive disorders, had been going through Hypercom monopreparation for at least four weeks. It was also a controlled intervention, with either a placebo or a synthetic standard antidepressant. Their symptoms were assessed with a depression scale or general assessment of clinical response. These criteria were more restrictive than those used in prior reviews.
Using a statistical analysis of the results they found that of sixty-eight possible trials, 37 trials met the inclusion criteria and contributed 26 comparisons with placebo and 14 comparisons with standard antidepressants. They excluded eighteen trials that had either healthy volunteers or patients without depression.
The results suggest only minor benefits of St. John’s Wort in patients with major depression and no benefit in patients with prolonged symptoms of depression. There is no evidence of its effectiveness in severe depression.
Reference
Dr med. Klaus Linde, Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität München, Kaiserstrasse 9, 80801 München, Germany