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St. John's wort and depression

BERLIN, GERMANY. St. John's wort (hypericum extract) is the most widely prescribed antidepressant in Germany and is gaining increased popularity in North America. German medical researchers have just released the results of a major study which shows that hypericum extract is effective in reducing moderate depression. The trial involved 66 men and 197 women who had been diagnosed with moderate depression. The patients were randomized to receive hypericum extract (350 mg of STEI 300 three times daily), a placebo or 100 mg of the tricyclic antidepressant imipramine (Tofranil) daily for eight weeks. Their depression score was measured using the Hamilton depression rating scale (and other scales) at the start of the study period and after 1, 2, 4, 6 and 8 weeks. Evaluation of the scores at 6 and 8 weeks showed that hypericum was significantly more effective than the placebo and as effective as imipramine in reducing depression. Side effects were more frequent in the imipramine group (46 per cent) than in the hypericum group (22 per cent), and the placebo group (19 per cent). The researchers conclude that the hypericum extract used in the study is effective in reducing mild to moderate depression, but warn that the findings may not be directly applicable to other hypericum extracts as there is a great variation in the concentration of active components. The STEI 300 brand used contains 0.2 to 0.3 per cent hypericin and pseudohypericin and 2 to 3 per cent hyperforin. NOTE: This study was funded by Steiner Arzneimittel, the manufacturer of STEI 300.
Philipp, Michael, et al. Hypericum extract versus imipramine or placebo in patients with moderate depression: randomised multicentre study of treatment for eight weeks. British Medical Journal, Vol. 319, December 11, 1999, pp. 1534-38
Linde, Klaus and Berner, Michael. Has hypericum found its place in antidepressant treatment? British Medical Journal, Vol. 319, December 11, 1999, p. 1539 (commentary)

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