Hypericum<i>in Seasonal Affective Disorder (SAD)</i>

Wheatley, David

doi:10.1185/03007999909115171

Cited by 50 publications

(23 citation statements)

References 10 publications

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“…The results suggested that SJW alone may achieve a similar efficacy to that of the combination 34 . These data seem to be confirmed by another study that found that Kira (a hypericum preparation) in monotherapy produced significant relief of SAD symptoms and that the addition of light therapy did not cause further significant improvement 35 . Despite the abundance of short-term trials, the efficacy of SJW has not yet been studied systematically in patients with psychotic depression, geriatric depression (where response rate may be lower and delayed), bipolar depression (where the primary treatment is mood stabilizer and there is a risk of increased mania with some antidepressants), premenstrual dysphoric disorder, dysthymia or double depression.…”

supporting

confidence: 73%

Efficacy and safety of St. John's wort for the treatment of major depression

Nangia

Waqar

Doraiswamy

2000

Public Health Nutr.

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supporting

confidence: 73%

Efficacy and safety of St. John's wort for the treatment of major depression

Nangia

Waqar

Doraiswamy

2000

Public Health Nutr.

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“…Evidence exists from placebo-controlled trials that HE shows efficacy in patients with depressive disorders accompanied by fatigue (Halama, 1991 ;Sommer and Harrer, 1994), whereas open studies report its effect in seasonal affective disorder (Kasper, 1997 ;Martinez et al, 1994 ;Wheatley, 1999). Apart from the RVS, atypical depression is characterized by 'leaden paralysis of the limbs' (i.e.…”

Section: Introductionmentioning

confidence: 94%

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Murck¹,

Fava

Alpert

et al. 2005

Int. J. Neuropsychopharm.

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Hypericum extract (HE) might be favourably active in depressed patients with reversed vegetative signs (RVS). Therefore, we performed an exploratory subgroup analysis of a three-armed study to compare HE, fluoxetine, and placebo in patients with major depressive disorder (MDD) in a 12 wk trial. A total of 135 patients were randomized to 12 wk treatment with HE LI 160 (900 mg/d), fluoxetine (20 mg/d), or placebo. Patients with RVS were defined in two steps, according to DSM-IV. First, patients with melancholy-related vegetative signs were excluded. Secondly, patients had to have at least one score of 2 for the items 22-26 of the HAMD-28 scale, which are related to hypersomnia and hyperphagia. Twenty-seven patients remained in the group. Analysis of covariance (ANCOVA) was applied using the HAMD-17 score. Secondly a chi2 test for response was performed, using the same and further an adapted criterium as in recently published studies. ANCOVA revealed a trend to a global difference. Post-hoc analysis showed a trend to superiority of HE compared to placebo and to fluoxetine, but a very large effect size for both differences. Fluoxetine was not different from placebo. The adapted response criterium showed a significant global difference as well as a significant superiority of HE over placebo and over fluoxetine. These data are based on a small sample size and must be considered tentative. A characterization of vegetative features of patients with depression could lead to an overall increased effect size in the treatment with HE.

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“…The effects of St John's wort extracts have been investigated in studies involving subjects with seasonal affective disorder (SAD) (Kasper 1997 ;Wheatley 1999), although as yet there have not been any trials that have included a placebo control group. Twenty individuals with SAD were randomised to receive St John's wort (LI 160) 300 mg three times daily (equivalent to hypericin 0.9 mg) with or without bright light therapy (Kasper 1997).…”

Section: Seasonal Affective Disordermentioning

confidence: 99%

“…After 4 weeks, there were significant reductions in HAMD scores in both groups, compared with baseline values ; there were no statistically significant differences between groups. Another study evaluated data from individuals with mild-to-moderate SAD who had used St John's wort 300 mg three times daily (equivalent to 0.9 mg hypericin), with (n l 133) or without light therapy (n l 168), for 8 weeks (Wheatley 1999). The study was not randomised and involved data collection by postal questionnaires.…”

Section: Seasonal Affective Disordermentioning

confidence: 99%

St John's wort (Hypericum perforatum L.): a review of its chemistry, pharmacology and clinical properties

Barnes

Anderson

Phillipson

2001

Journal of Pharmacy and Pharmacology

688

462

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The chemical composition of St. John's wort has been well-studied. Documented pharmacological activities, including antidepressant, antiviral, and antibacterial effects, provide supporting evidence for several of the traditional uses stated for St John's wort. Many pharmacological activities appear to be attributable to hypericin and to the flavonoid constituents ; hypericin is also reported to be responsible for the photosensitive reactions that have been documented for St. John's wort. With regard to the antidepressant effects of St John's wort, hyperforin, rather than hypericin as originally thought, has emerged as one of the major constituents responsible for antidepressant activity. Further research is required to determine which other constituents contribute to the antidepressant effect.Evidence from randomised controlled trials has confirmed the efficacy of St John's wort extracts over placebo in the treatment of mild-to-moderately severe depression. Other randomised controlled studies have provided some evidence that St John's wort extracts are as effective as some standard antidepressants in mild-to-moderate depression. There is still a need for further trials to assess the efficacy of St John's wort extracts, compared with that of standard antidepressants, particularly newer antidepressant agents, such as the selective serotonin reuptake inhibitors (recent comparative studies with fluoxetine and sertraline have been conducted). Also, there is a need for further studies in well-defined groups of patients, in different types of depression, and conducted over longer periods in order to determine longterm safety. St John's wort does appear to have a more favourable short-term safety profile than do standard antidepressants, a factor that is likely to be important in patients continuing to take medication.Concerns have been raised over interactions between St John's wort and certain prescribed medicines (including warfarin, ciclosporin, theophylline, digoxin, HIV protease inhibitors, anticonvulsants, selective serotonin reuptake inhibitors, triptans, oral contraceptives) ; advice is that patients taking these medicines should stop taking St John's wort, generally after seeking professional advice as dose adjustment of conventional treatment may be necessary.

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Hypericumin Seasonal Affective Disorder (SAD)

Cited by 50 publications

References 10 publications

Efficacy and safety of St. John's wort for the treatment of major depression

Efficacy and safety of St. John's wort for the treatment of major depression

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

St John's wort (Hypericum perforatum L.): a review of its chemistry, pharmacology and clinical properties

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