Positive Health Online

Abstract

GASTER and HOLROYD, Department of Medicine, University of Washington, Seattle, USA barakg@u.washington.edu conducted a systematic review (40 references) of the English language literature regarding the efficacy, safety and availability of St John's wort in the treatment of depression .

Background

Methodology

The authors selected studies using randomized, controlled, double-blind trials ; methodological quality was assessed using a standardized checklist, and data regarding pharmacology, cost, regulation and safety were extracted. 8 studies were identified and found to be of generally good methodological quality. These studies provided data suggesting that St John's wort is more effective than placebo in the treatment of mild to moderate depression . The absolute increased response rate with the use of St John's wort ranged from 23% to 55% higher than with placebo, and 6% to 18% lower compared with tricyclic antidepressants.

Results

Conclusion

More data are required to assess both its use in severe depression and its efficacy compared with other antidepressants. Side effect rates were low. St John's wort is currently largely unregulated; however the Food and Drug Administration is reviewing plans to tighten regulations.

References

Gaster B and Holroyd J. St John's wort for depression: a systematic review. Archives of Internal Medicine 160(2): 152-6. 24 Jan 2000.