The efficacy and safety of St. John’s wort extract in depression therapy compared to SSRIs in adults: A meta-analysis of randomized clinical trials

Xin, Zhao; Zhang, Hong; Wu, Yue; Yu, Chun Pong

doi:10.17219/acem/152942

Cited by 8 publications

(4 citation statements)

References 44 publications

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“…Furthermore, the link between air pollution and the pathogenesis of depression has been proven [ 53 ]. Novel therapeutics for neuropsychiatric conditions are under extensive study [ 54 , 55 ].…”

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confidence: 99%

Integrating Armchair, Bench, and Bedside Research for Behavioral Neurology and Neuropsychiatry: Editorial

2022

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confidence: 99%

Integrating Armchair, Bench, and Bedside Research for Behavioral Neurology and Neuropsychiatry: Editorial

2022

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“…This review also offers novel insights into the role of specific modes and intensities of exercise in alleviating depressive symptoms, providing valuable information for future investigations. However, the consideration of exercise interventions as clinical treatments for mental disorders such as depression requires more rigorous randomized controlled trials to evaluate the efficacy of exercise interventions in treating depression [148][149][150][151]. While the effects of different types, intensities, frequencies, and durations of exercise on depression have been studied, further research is needed to determine the optimal exercise regimen for individuals with depression.…”

Section: Discussionmentioning

confidence: 99%

Exercise for Mental Well-Being: Exploring Neurobiological Advances and Intervention Effects in Depression

Ren

Xiao

2023

Life

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Depression is a common mental disorder in which patients often experience feelings of sadness, fatigue, loss of interest, and pleasure. Exercise is a widely used intervention for managing depression, but the specific molecular mechanisms underlying its antidepressant effect are unclear. In this narrative review, we aim to synthesize current knowledge on the molecular, neural, and physiological mechanisms through which exercise exerts its antidepressant effect and discuss the various exercise interventions used for managing depression. We conducted a narrative review of the literature on the topic of exercise and depression. Our review suggests that exercise impacts peripheral tryptophan metabolism, central inflammation, and brain-derived neurotrophic factors through the peroxisome proliferator-activated receptor γ activating factor 1α (PGC-1α) in skeletal muscles. The uncarboxylated osteocalcin facilitates “bone-brain crosstalk”, and exercise corrects atypical expression of brain-gut peptides, modulates cytokine production and neurotransmitter release, and regulates inflammatory pathways and microRNA expression. Aerobic exercise is recommended at frequencies of 3 to 5 times per week with medium to high intensity. Here we highlight the significant potential of exercise therapy in managing depression, supported by the molecular, neural, and physiological mechanisms underlying its antidepressant effect. Understanding the molecular pathways and neural mechanisms involved in exercise’s antidepressant effect opens new avenues for developing novel therapies for managing depression.

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“…For example, a meta-analysis of clinical trials performed by Linde and colleagues in 2008 indicated Hypericum perforatum extract to be superior to a placebo in patients with major depression, to be similarly effective, and to have fewer side effects than standard antidepressants [ 91 ]. Thus, the volume of clinical research and meta-analytic data [ 69 , 71 , 88 ] reinforces the fact that Hypericum perforatum is the most studied, probably safe and effective adaptogenic herbal extract that might be recommended to practitioners as part of an integral clinical treatment to reduce depressive symptoms. Nevertheless, more research is warranted to evaluate factors that influence response to treatment, such as the type of extract, the duration of the disorder and age of the participants, among others.…”

Section: Discussionmentioning

confidence: 99%

Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity

Sánchez-Rojas

Cuchimba

Pineda

et al. 2023

IJERPH

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Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John’s Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John’s Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.

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The efficacy and safety of St. John’s wort extract in depression therapy compared to SSRIs in adults: A meta-analysis of randomized clinical trials

Abstract: The efficacy and safety of St. John's wort extract in depression therapy compared to SSRIs in adults: A meta-analysis of randomized clinical trials [published online as ahead of print on October 11, 2022].

Cited by 8 publications

References 44 publications

Integrating Armchair, Bench, and Bedside Research for Behavioral Neurology and Neuropsychiatry: Editorial

Integrating Armchair, Bench, and Bedside Research for Behavioral Neurology and Neuropsychiatry: Editorial

Exercise for Mental Well-Being: Exploring Neurobiological Advances and Intervention Effects in Depression

Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity

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