TY - JOUR
T1 - St. John's wort (Hypericum perforatum)
T2 - A review of the current pharmacological, toxicological, and clinical literature
AU - Greeson, Jeffrey M.
AU - Sanford, Britt
AU - Monti, Daniel A.
N1 - Funding Information:
Another recent systematic review of eight randomized, double-blind studies of Hypericum vs placebo or TCA medication generally supports the results of previous reviews, however this study found that the overall response rate for patients treated with Hypericum was 6–18% lower than the response rate for patients treated with a TCA (Gaster and Holroyd 2000). A multicenter RCT sponsored by the National Institutes of Health is currently underway (NCCAM 1997). This trial, the first in the U.S. to investigate the efficacy of Hypericum in relation to a selective serotonin reuptake inhibitor (SSRI), will compare Hypericum to placebo and sertraline in 336 patients with major depression. The only published study to compare Hypericum against an SSRI (fluoxetine, 20 mg/day) found that the herb was equally efficacious in treating elderly patients with mild to moderate depressive episodes (Harrer et al. 1999).
PY - 2001
Y1 - 2001
N2 - Rationale: St. John's wort (Hypericum perforatum) has recently gained popularity as an alternative treatment for mild to moderate depression. Given the current widespread use of this herbal remedy, it is important for medical professionals to understand the potential pharmacological pathways through which Hypericum may exert an antidepressant effect. Objectives: (1) To review the current pharmacological, toxicological, and clinical literature available on Hypericum, and (2) to provide a synthesis of this information into a form that may be easily used by health care providers. Method: A comprehensive review of the recent scientific literature (January 1990-March 2000) was performed using the following electronic databases and reference publications: MEDLINE, The Cochrane Library, HealthSTAR, Current Contents (all editions), European Scientific Cooperative on Phytotherapy monographs, German Commission E monographs, and the Physicians' Desk Reference for Herbal Medicines, 1st edition. Results: One hundred and seven (107) publications in the English language and three publications in German were included in the review. Collectively, the data suggest that therapeutic preparations of Hypericum extract appear to exert potentially significant pharmacological activity within several neurochemical systems believed to be implicated in the pathophysiology of depression. However, little information exists regarding the safety of Hypericum, including potential herb-drug interactions. Conclusions: Additional research on the pharmacological and biochemical activity of Hypericum and its several bioactive constituents is necessary to further elucidate the mode(s) of antidepressant action. Given what is currently known and unknown about the biological properties of Hypericum, those who choose to use this herb should be closely monitored by a physician.
AB - Rationale: St. John's wort (Hypericum perforatum) has recently gained popularity as an alternative treatment for mild to moderate depression. Given the current widespread use of this herbal remedy, it is important for medical professionals to understand the potential pharmacological pathways through which Hypericum may exert an antidepressant effect. Objectives: (1) To review the current pharmacological, toxicological, and clinical literature available on Hypericum, and (2) to provide a synthesis of this information into a form that may be easily used by health care providers. Method: A comprehensive review of the recent scientific literature (January 1990-March 2000) was performed using the following electronic databases and reference publications: MEDLINE, The Cochrane Library, HealthSTAR, Current Contents (all editions), European Scientific Cooperative on Phytotherapy monographs, German Commission E monographs, and the Physicians' Desk Reference for Herbal Medicines, 1st edition. Results: One hundred and seven (107) publications in the English language and three publications in German were included in the review. Collectively, the data suggest that therapeutic preparations of Hypericum extract appear to exert potentially significant pharmacological activity within several neurochemical systems believed to be implicated in the pathophysiology of depression. However, little information exists regarding the safety of Hypericum, including potential herb-drug interactions. Conclusions: Additional research on the pharmacological and biochemical activity of Hypericum and its several bioactive constituents is necessary to further elucidate the mode(s) of antidepressant action. Given what is currently known and unknown about the biological properties of Hypericum, those who choose to use this herb should be closely monitored by a physician.
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U2 - 10.1007/s002130000625
DO - 10.1007/s002130000625
M3 - Review article
C2 - 11243487
AN - SCOPUS:0035106685
SN - 0033-3158
VL - 153
SP - 402
EP - 414
JO - Psychopharmacology
JF - Psychopharmacology
IS - 4
ER -