St. John's wort ineffective for depression

DURHAM, N.C. The largest clinical trial performed to date on the popular herbal supplement St. John's wort (Hypericum perforatum) has found it to be no more effective than placebo for the treatment of a moderately severe form of major depression, according to researchers at Duke University Medical Center. Major depression, also called major depressive disorder, is one of the most common forms of depression.

Researchers designed the study to test the efficacy of St. John's wort (SJW) versus placebo for the treatment of major depression. In their study, they used the antidepressant sertraline (trade name Zoloft), which is a selective serotonin reuptake inhibitor (SSRI), as a "control" to measure the sensitivity of the study for detecting antidepressant effects of hypericum. SSRIs such as sertraline are a class of drug found to be effective in treating several forms of depression.

"Major depression is treatable, but this research suggests that major depression of at least moderate severity should not be treated with St. John's wort," said Jonathan R.T. Davidson, M.D., director of the Anxiety and Traumatic Stress Program at Duke and principal investigator of the study. "Rather than self-medicate with an over-the-counter medication or supplement, patients are strongly advised to consult an appropriate healthcare provider to assess the best treatment for a depressive episode."

Another author on the study, Robert Califf, M.D., director of the Duke Clinical Research Institute, emphasized the dangers of inadequate studies of St. John's wort and other herbal remedies.

"As long as these types of products remain available to the public without the protection of adequate, controlled and unbiased studies, taking them is like playing Russian roulette with your health," he said.

Study results appear in the April 10, 2002 issue of the Journal of the American Medical Association. Duke University Medical Center, Duke Clinical Research Institute (DCRI)

Contact: Tracey Koepke
Duke University

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