St John's wort for depression--an overview and meta-analysis of randomised clinical trials

Abstract

There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders. Further studies comparing extracts with standard antidepressants in well defined groups of patients and comparing different extracts and doses are needed.

Interaction of Glutathione S-Transferase with Hypericin: A Photophysical Study

“…Hypericin displays light-induced activity against several types of viruses, including the human immunodeficiency virus (HIV), [9][10][11] as well as antiproliferative and cytotoxic effects on tumor cells. [12][13][14][15] Hypericin is also a potent antidepressant, 16,17 exhibits light-dependent inhibition of protein kinase C (PKC), which has been suggested to be a locus of its antiviral activity, 18 and is reported to possess numerous other types of biological behavior. [19][20][21] Hypericin, like other anticancer drugs, also induces apoptosis.…”

Effects of Standardized Extracts of St. John's Wort on the Single-Unit Activity of Serotonergic Dorsal Raphe Neurons in Awake Cats Comparisons with Fluoxetine and Sertraline

“…Since the publication of that influential report, several other systematic reviews (and one metaanalysis) have appeared which further support the antidepressant efficacy of hypericum (Josey and Tackett 1999;Kim et al 1999;Stevinson and Ernst 1999;Gaster and Holroyd 2000). Furthermore, in comparison with other antidepressants, St. John's wort is well tolerated and has a low side effect profile (Linde et al 1996;Ernst et al 1998 Despite its widespread use, the active constituents and mechanism of antidepressant action of St. John's wort remain largely unknown (Bennett et al 1998;Nathan 1999). A number of studies have shown that crude hypericum preparations and some of the constituents can inhibit monoamine oxidase (MAO) activity in vitro (Demisch et al 1989;Thiede and Walper 1994;Cott 1997;.…”

“…Since the publication of that influential report, several other systematic reviews (and one metaanalysis) have appeared which further support the antidepressant efficacy of hypericum (Josey and Tackett 1999;Kim et al 1999;Stevinson and Ernst 1999;Gaster and Holroyd 2000). Furthermore, in comparison with other antidepressants, St. John's wort is well tolerated and has a low side effect profile (Linde et al 1996;Ernst et al 1998). Due to the growing popularity of St. John's wort in the United States, the National Institutes of Health (NIH) has recently sponsored a large, multicenter clinical trial to assess the long-term efficacy and safety of St. John's wort in treating severely depressed patients (Bunk 1999;Vitiello 1999).…”

“…The antidepressant efficacy of hypericum extracts has been documented in a number of small, double-blind, placebo-controlled studies, conducted mainly in Europe (Volz 1997). A widely cited meta-analysis of 23 randomized clinical trials concluded that hypericum extracts were significantly superior to placebo and comparable to tricyclic antidepressant drugs in alleviating depressive symptoms (Linde et al 1996). Since the publication of that influential report, several other systematic reviews (and one metaanalysis) have appeared which further support the antidepressant efficacy of hypericum (Josey and Tackett 1999;Kim et al 1999;Stevinson and Ernst 1999;Gaster and Holroyd 2000).…”

Pharmacokinetic Herb-Drug Interactions: Insight into Mechanisms and Consequences

“…Some clinical studies have provided evidence that it is as effective as conventional antidepressants. Although the anti-depressive mechanism is not fully understood, its therapeutic effects have been confirmed in several studies when compared with placebo or standard antidepressant agents [101]. Even though it is widely obtained as an over-the-counter remedy, knowledge about the pharmacokinetics 20 of ingredients and drug interactions of St John's wort is not commensurate.…”