in JAMA Says Evidence Sketchy for St. John's Wort
In an article
coming out in the April 11 Journal of the American Medical Association,
a group of researchers, including faculty of the Department of Psychiatry
and Behavioral Sciences at Emory University School of Medicine, have
concluded that St. John's wort (hypericum) should not be used as a treatment
for major depression until further testing shows that it is effective.
St. John's wort, an herbal supplement, is widely used by the public
as an over-the-counter medication for depression, but it is not labeled
as a drug and has never been evaluated or approved by the U.S. Food
and Drug Administration (FDA).
The double-blind, randomized
study was conducted by twelve community and academic psychiatric research
facilities around the country. Study participants were 18 years of age
or older with moderate to severe depression. The participants were given
placebo, an approved anti-depressant, Zoloft (sertraline), or St. John's
wort for eight weeks. Those who responded continued in the study for
another 18 weeks.
There was little difference
in improvement of depressive symptoms between the placebo group (31.9%),
the Zoloft group (24.8%) and the St. John's wort group (23.9%).
"These findings demonstrate
that the use of St. John's Wort by the general public to treat depression
is probably not advisable at this time," said Charles Nemeroff, M.D.,
Ph.D., Reunette W. Harris Professor and Chairman of the Department of
Psychiatry and Behavioral Sciences at Emory University School of Medicine.
"St. John's wort has been
reported to have significant effects on the actions of concurrently
prescribed medications that can be deleterious to patients. Additionally,
depression is a serious, and possibly deadly, disorder caused by an
imbalance in the chemistry of the brain. Unfortunately, the stigma connected
with depression is still so widespread that many Americans either remain
untreated, or head to the health food store to pick up a supplement
that they think can help. Until data is available that proves the efficacy
of a product, patients should be encouraged to see their family doctor
before using any type of self-medication."
St. John's wort is made from
extracts of Hypericum perforatum, a plant native to Europe and parts
of Asia and Africa that blooms in late June, close to the birthday of
St. John the Baptist. The plant is known as Klamath weed in Oregon and
elsewhere in the Pacific Northwest where it has begun to grow wild.
Tests in Europe have suggested that St. John's wort has the potential
to relieve depression without the side effects of pharmaceutical products.
It is the most widely prescribed antidepressant in Germany and prescribed
throughout Europe for depression, anxiety and sleep disorders.
The study was supported by
the National Center for Complementary and Alternative Medicine and the
National Institute of Mental Health, Lichtwer Pharma A.G. (Berlin, Germany)
and Pfizer, Inc. (New York).