The updated review of 37 trials, involving 4,925 patients, reaffirms earlier findings that St. John's Wort:

• Reduces symptoms of mild-to-moderate depression among adults in a manner similar to antidepressant drugs;
• Causes fewer side effects than some of the older antidepressants on the market; and
• Causes slightly fewer side effects compared with selective serotonin reuptake inhibitors, or SSRIs, the class of antidepressants most recently developed.

The review was led by Professor Klaus Linde of the Centre for Complementary Medicine Research at Technical University in Munich, Germany. The reviewers caution that "uncontrolled use of [St. John's Wort] is problematic because serious interactions can occur" with a number of frequently used antidepressants and that physicians should regularly ask their patients about their use of St. John's Wort.

The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, holds that St. John's Wort is not a proven therapy for depression. The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

All studies were double-blind, randomized clinical trials involving patients with depressive disorders. All involved comparisons between St. John's Wort and placebos or synthetic antidepressants given for at least four weeks.

St. John's Wort is available over the counter in the United States, where lifetime depression has an estimated pr
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Contact: Klaus Linde
Klaus.Linde@lrz.tu.muenchen.de
Center for the Advancement of Health
16-May-2005