Controlled study finds no efficacy for St. John’s Wort in major depression – News and Comment – Brief Article

Kendrick Frazier

The lead News & Comment article in our May/June 2002 issue reported that a major, multicenter, controlled study of the effectiveness of St. John’s Wort in treating major depression was undergoing final peer review and about to be published.

That study has now been published, in the Journal of the American Medical Association (287 [14]: 1807–1814, April 10, 2002). The results are not good news for advocates of the herb’s value in treating depression.

“This study fails to support the efficacy of Hypericum perforatum [St. John’s Wort] in moderately severe major depression,” the authors conclude. “The result may be due to low assay sensitivity of the trial, but the complete absence of trends suggestive of efficacy for H. perforatum is noteworthy.”

The double-blind, randomized, placebo-controlled trial was conducted in twelve academic and community psychiatric research clinics in the United States. It involved 340 adult outpatients with major depression. Patients were randomly assigned to receive St. John’s Wort, a placebo, or sertraline (as an active comparator) for eight weeks. After eight weeks patients could continue with blinded treatment for another eighteen weeks.

Of the two primary outcome measures, neither sertraline nor St. John’s Wort was significantly different from the placebo.

At the American Association for the Advancement of Science meeting in February in Boston, the study’s principal investigator, Jonathan R.T. Davidson, M.D., of the Duke University Medical Center, described the study protocol as “a kind of model for studies of depression.” He said it overcame limitations and uncertainties of earlier studies.

The study results were reported in JAMA by Davidson and twenty-five colleagues at the twelve research clinics, comprising the Hypericum Depression Trial Study Group.

“We have found no evidence for a superior effect of hypericum relative to placebo,” say the authors. “Hypericum should not be substituted for standard clinical care of proven efficacy, including antidepressant medications and specific psychotherapies, for the treatment of major depression of modern severity.”

The research was funded by the National Center for Complementary and Alternative Medicine and the National Institute for Mental Health.

Kendrick Frazier is Editor of the SKEPTICAL INQUIRER.

COPYRIGHT 2002 Committee for the Scientific Investigation of Claims of the Paranormal

COPYRIGHT 2002 Gale Group

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