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Research: ERNST, Department of C
Listed in Issue 75
Abstract
ERNST, Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter, Devon EX2 4NT, UK, E.Ernst@exeter.ac.uk, reviewed (76 references) published data from clinical studies of commonly used herbs to assess their risk-benefit profiles .
Background
The use of herbal remedies is on the increase, so a critical assessment of their risks versus benefits is warranted.
Methodology
Ernst reviews available clinical evidence for the safety and efficacy of Ginkgo, St. John's wort, Ginseng, Echinacea, Saw palmetto and Kava . Wherever possible, the author draws his conclusions from the findings of systematic reviews of randomized clinical trials .
Results
Ginkgo appears to have some benefits in dementia and intermittent claudication ; claims for its usefulness for memory loss and tinnitus, however, remain questionable. St. John's wort can reduce the symptoms of mild-to-moderate depression ; however, its potential to interact with a number of conventional medicines is a cause for concern . Ginseng has been investigated in some well-conducted clinical trials, but the results provide no evidence of its efficacy in any condition so far examined. The data on Echinacea indicate that it may help to prevent or attenuate the symptoms of upper respiratory tract infections – more extensive trials are needed to confirm this. In short-term studies, Saw palmetto was able to reduce the symptoms of benign prostatic hyperplasia . Kava is an effective treatment for anxiety in the short term .
Conclusion
The evidence indicates that some of these herbal medicines are efficacious . Each of the herbal medicines has some side effects, but their potential benefits are probably greater than their risks . The available data, however, does not provide a complete picture, and further well-designed, larger trials are needed to provide reliable risk-benefit assessments.
References
Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals of Internal Medicine 136 (1): 42-53. Jan 2002.
