This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (105)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Social Bookmarking   What's this?

A Systematic Review

Barak Gaster, MD; John Holroyd, MD

Arch Intern Med. 2000;160:152-156.

To address whether St John's wort is useful for the treatment of depression we attempted to retrieve all English-language articles with data on the efficacy, safety, and availability of St John's wort. Randomized, controlled, double-blind trials were selected and assessed for methodological quality using a standardized checklist, and data on pharmacology, cost, regulation, and safety were extracted. Eight studies were identified, found to be of generally good methodological quality, and determined to provide a modest amount of data to suggest that St John's wort is more effective than placebo in the treatment of mild to moderate depression. The absolute increased response rate with the use of St John's wort ranged from 23% to 55% higher than with placebo, but ranged from 6% to 18% lower compared with tricyclic antidepressants. More data are required to assess both its use in severe depression and its efficacy compared with other antidepressants. Rates of side effects were low. As a dietary supplement, St John's wort is currently largely unregulated, but the Food and Drug Administration is reviewing plans to tighten its regulatory oversight.

From the Department of Medicine, University of Washington, Seattle.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(2):245-246.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A proteomic investigation of similarities between conventional and herbal antidepressant treatments
Pennington et al.
J Psychopharmacol 2009;23:520-530.
ABSTRACT  

Severe drug induced acute hepatitis associated with use of St John's wort (Hypericum perforatum) during treatment with pegylated interferon {alpha}
Piccolo et al.
BMJ Case Reports 2009;2009:bcr0820080761-bcr0820080761.
ABSTRACT | FULL TEXT  

St John's wort for depression: Meta-analysis of randomised controlled trials
LINDE et al.
Br. J. Psychiatry 2005;186:99-107.
ABSTRACT | FULL TEXT  

Phytochemical Assays of Commercial Botanical Dietary Supplements
Krochmal et al.
Evid Based Complement Alternat Med 2004;1:305-313.
ABSTRACT | FULL TEXT  

St. John's Wort: A Systematic Review of Adverse Effects and Drug Interactions for the Consultation Psychiatrist
Hammerness et al.
Psychosomatics 2003;44:271-282.
ABSTRACT | FULL TEXT  

How objective are systematic reviews? Differences between reviews on complementary medicine
Linde and Willich
JRSM 2003;96:17-22.
ABSTRACT | FULL TEXT  

Women and Depression: A Phytotherapist's Approach
Romm
Complementary Health Practice Review 2003;8:25-39.
ABSTRACT  

Suspected withdrawal syndrome after cessation of St. John's wort
Dean et al.
The Annals of Pharmacotherapy 2003;37:150-150.
FULL TEXT  

Herbal Remedies
De Smet
NEJM 2002;347:2046-2056.
FULL TEXT  

The Risk-Benefit Profile of Commonly Used Herbal Therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava
Ernst
ANN INTERN MED 2002;136:42-53.
ABSTRACT | FULL TEXT  

Herbal Medicines and Perioperative Care
Ang-Lee et al.
JAMA 2001;286:208-216.
ABSTRACT | FULL TEXT  

St John's Wort and Major Depression
Cott et al.
JAMA 2001;286:42-45.
FULL TEXT  

Managing Depression in Outpatients
Paley et al.
NEJM 2001;344:1251-1253.
FULL TEXT  

Effectiveness of St John's Wort in Major Depression: A Randomized Controlled Trial
Shelton et al.
JAMA 2001;285:1978-1986.
ABSTRACT | FULL TEXT  

St John's Wort and Literature Quotations
Mennini et al.
Arch Intern Med 2001;161:1016-1017.
FULL TEXT  

Current topic: Complementary and alternative medicine for children: does it work?
Kemper
Arch. Dis. Child. 2001;84:6-9.
ABSTRACT | FULL TEXT  

Managing Depression in Medical Outpatients
Whooley and Simon
NEJM 2000;343:1942-1950.
FULL TEXT  

Other articles noted
Evid. Based Nurs. 2000;3:106-112.
FULL TEXT  

St John's Wort Interaction With Digoxin
Cheng
Arch Intern Med 2000;160:2548-2548.
FULL TEXT  

Hyperforin in Extracts of St John's Wort (Hypericum perforatum) for Depression
Vormfelde et al.
Arch Intern Med 2000;160:2548-2549.
FULL TEXT