Issue 43
St. John's wort - at least as effective as prescribed
anti-depressants
British doctors should sit up and take notice of recent
research showing the herb St. John's wort to be a safe and effective alternative
to the prescribed anti-depressant, imipramine. Whilst doctors in the UK are
generally ignorant of the benefits of St. John's wort, the same cannot be
said of their German counterparts, who write out 3 million prescriptions for
the herb every year.
St. John's wort has been used medicinally since ancient
times for a number of health complaints, but by far the most popular and perhaps
successful use has been for the treatment of mild Depression.
At least 19 double-blind placebo-controlled studies have demonstrated that St.
John's wort is more effective than placebo in the treatment of mild to moderate
depression, but few have compared the efficacy of the herb with prescribed
anti-depressants. In a recent double-blind placebo-controlled study, scientists
compared the efficacy and safety of a standardised St. John's wort extract
with the tricyclic antidepressant imipramine and a placebo. 263 volunteers were
randomly allocated to receive either St. John's wort extract (1050mg/d),
100mg imipramine or placebo for 8 weeks.
Throughout the study period the severity of Anxiety
and depression was assessed. Simultaneous analysis demonstrated that St.
John's wort was equivalent in efficacy to imipramine with far fewer side effects.
However, the researchers point out that these results cannot be applied to all
St. John's wort preparations as levels of active compounds such as hypericin,
hyperforin and certain flavonols can vary considerably.
For complete confidence in a herbal product it is important
to choose a standardised preparation offering a consistent intake of important
herb compounds. In conclusion, scientists believe that St. John's wort should
be considered as an alternative first choice treatment in most cases of mild
to moderate depression.
However, this does not mean that the herb should become
a prescription only medicine. Instead, licensing procedures should be established
so that the herb is freely available and can be recommended by doctors.
British Medical Journal, 1999, 319:1534-9.
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