St John's wort for depression: Time for a different perspective?
Section snippets
Background
St John's wort (SJW) (Hypericum perforatum) is a flowering plant that is a member of the family Hypericaceae. It is widely used as a herbal remedy particularly for self-treatment for depression. The active parts of the plant are the dried, above-ground parts containing several active constituents of which two, hypericin and hyperforin, are understood to be the most significant.1 The antidepressant action is probably mediated by serotonergic, noradrenergic and dopaminergic system activation and
Aim and objectives
The aim of this study was to evaluate the evidence from a range of sources on the effectiveness, safety and patient experience of SJW (Hypericum) for the treatment of depression.
Main results
Numbers of studies found:Meta-analyses 10 Systematic reviews 25 (including the above) Qualitative research 1 study
Conclusions
SJW has received intensive and continued attention since the initial indications of its potential effectiveness in the treatment of depression. Systematic reviews and meta-analyses of its effectiveness continue to be conducted and published. Estimates of effectiveness have varied due to methodological differences, a finding reported previously by Linde and Willich.88 While exact measures of its effectiveness in comparison to placebo have varied, positive results have been obtained even when
Note
After this study was completed, an update of the Cochrane review was published89 which has now replaced the review mentioned in this paper.
Acknowledgements
Professor Irving Kirsch, Faculty of Health and Social Work, University of Plymouth and Hugh McGuire, CCDAN Trials Search Coordinator, Institute of Psychiatry for helpful comments on the draft of this paper.
The Project Advisory Group and Specialist Advisory Group (mental health) for the NHS Priorities Project for advice and support to the project.
The NHS Priorities Project is funded by the Department of Health. The views and opinions expressed are those of the authors and do not necessarily
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Present address: Royal London Homoeopathic Hospital, London, UK.