Positive Health Online

Abstract

BRENNER and colleagues, St. John's Episcopal Hospital, Far Rockaway, New York 11691, USA compared hypericum (St. John's wort) to the serotonin reuptake inhibitor (SSRI) sertraline for the treatment of depression .

Background

Hypericum has been shown to be as efficacious and well tolerated as standard antidepressants in treating [mild-to-moderate] depression, but has not been compared with SSRIs.

Methodology

19 female and 11 male outpatients of a community hospital, mean age 45.5 years, with mild-to-moderate depression were randomised in a double-blind manner to receive 600 mg/day of a standardised extract of hypericum (LI 160) or 50 mg/day sertraline for 1 week, followed by 900 mg/day hypericum or 75 mg/day sertraline respectively for 6 weeks. Severity of depression symptoms was assessed on the Hamilton Rating Scale for Depression (HAM-D) and the Clinical Global Impression (CGI) scale.

Results

Symptom severity was significantly reduced in both treatment groups (p<0.01). A clinical response (defined as a 50% reduction in HAM-D scores) was seen in 47% of patients who received hypericum and 40% of those who received sertraline ; the difference between the two groups was not statistically significant . Both hypericum and sertraline were well tolerated . A post-hoc power analysis indicated that the failure to detect a statistically significant difference between the two treatments was primarily due to a lack of clinical differences rather than the small patient sample size.

Conclusion

Hypericum extract LI 160 was at least as effective as the SSRI sertraline in the treatment of mild-to-moderate depression in this small group of outpatients.

References

Brenner R et al. Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study. Clinical Therapeutics 22 (4): 411-9. Apr 2000.