Anxiety hypericum

Enns MW, Cox BJ, Parker JD, Guertin JE. (1998). Confirmatory factor analysis of the Beck anxiety and depression inventories in patients with major depression. J Affective Disord. 47(1-3) 195-200. Erdelmeier CA. (1998). Hyperforin, possibly the major non-nitrogenous secondary metabolite of Hypericum perforatum L. Pharmacopsychiatry. 31(suppl 1) 2-6. 

St. John s wort (Hypericum perforatum) Relieves anxiety and depression prevents insomnia relieves some skin disorders... 

St. John s wort (Hypericum perforatum) is a perennial wildflower indigenous to Europe, North Africa, and western Asia (Fig. 1) and has been used for medicinal purposes for over two millennia. As far back as the early 16th century, St. John s wort was used primarily to treat anxiety, depression, and sleep disorders. In the late 20th and early 21st century, St. John s wort has been recommended for the treatment of mild to moderate depression (7). In support of its use for the treatment of mild to moderate depression, a number of clinical trials have demonstrated that St. John s wort has comparable efficacy to the tricyclic antidepressants (i.e., imipramine) and selective serotonin reuptake inhibitors (e.g., fluoxetine and paroxetine) (8-13). 

Stevia Stevia rebaudiana) Uses Natural sweetener, hypoglycemic and hypotensive properties Actions Multiple chemical components sweetness d/t glycoside, stevioside hypotensive effect may be d/t diuretic action or vasodilation action Available forms Liq extract, powder, caps Notes/SE HA, dizziness, bloating Interactions T Hypotensive effects W/ antihypertensives esp CCB, diuretics EMS Monitor BP does not encourage dental caries may -1-glucose St. John s Wort (Hypericum perforatum) Uses Mild-mod depression, anxiety, anti-inflammatory, immune stimulant/anti-HIV/antiviral, gastritis, insomnia, vitiligo Action MAOI in vitro, not in vivo bacteriostatic bactericidal, T capillary blood flow, uterotonic activity in animals Efficacy Variable benefit w/ mild-mod depression in several trials, but not always seen in clinical practice Available forms Teas, tabs, caps, tine, oil ext for topical use Dose 2-4 g of herb or 0.2-1 mg of total hypericin (standardized extract) daily Notes/SE Photosensitivity (use sunscreen) rash, dizziness, dry mouth, GI distress Interactions Enhance MAOI activity, EtOH, narcotics, sympathomimetics EMS T Risk of photosensitivity Rxns t effects of opioids and sympathomimetics... 

St. John s wort is derived from the flowers of the Hypericum perforatum plant that grows throughout England, Europe, Asia, and parts of the United States. This herbal supplement has been used extensively to treat symptoms of depression and anxiety. Although the details are unclear, St. John s wort probably contains several chemicals that alter the balance of central nervous system (CNS) neurotransmitters affecting mood and behavior.46,84 As discussed in Chapter 7, depression seems to be associated with a fundamental defect in amine neurotransmitters such as serotonin, norepinephrine, and dopamine. St. John s wort may promote changes in these neurotransmitters in a manner similar to conventional prescription antidepressants.56,84 Many people have therefore used St. John s wort as an alternative medication to help improve mood and resolve the symptoms of depression.46,72... 

St. John s wort. The St. John s wort plant (Hypericum perforatum Figure 6.4) is an increasingly popular herbal supplement that proponents claim has the ability to cure a vast array of ailments. St. John s wort appears to boost the release of the neurotransmitter serotonin in the brain, which may be the reason it is able to treat anxiety and depression. The herb contains numerous substances, two of which, hypericin and hyperforin, maybe key active ingredients. St. John s wort appears to be effective in relieving the muscle pain associated with fibromyalgia and the tissue pain associated with hemorrhoids. The herb comes in tablet, capsule, cream, and ointment forms and must be taken for several weeks before it takes full effect. St. John s wort should not be taken with antidepressants such as... 

Somatoform disorders are a group of diseases that include the complaint of physical pain, which lead the patient to believe they have a physical disease, though none can be found by medical investigation (24). A study was conducted where 151 patients received either Hypericum 300 mg twice daily or placebo. Efficacy was measured using the Hamilton Anxiety Scale, subfactor somatic anxiety (HAMA-SOM). After 6 weeks, the average HAMA-SOM... 

There are numerous accounts of anecdotal evidence supporting the use of St. John s wort for premenstrual syndrome (PMS) (36). One open, uncontrolled study was conducted to determine the efficacy of St. John s wort in treating PMS. The primary outcome was measured by a daily symptom checklist of 17 symptoms rated on a scale of 0 to 4 based on the Hospital Anxiety and Depression (HAD) scale and modified Social Adjustment Scale (SAS-M) broken down into four subscales mood, behavior, pain, and physical. A total of 25 women were selected to participate in the study in which they received 300 mg hypericum standardized to 900 p.g hypericin daily. The results from the daily symptoms survey after the first cycle show a statistically significant reduction from the baseline value of 128.42 to 70.11. After the second cycle, there was a further reduction to 42.74. Of the four subscales, St. John s wort had the greatest improvement on the mood subscale (57%) and the least improvement on the physical subscale (35%). Of the individual symptoms, crying (92%) and depression (85%) were improved the most with treatment, and food cravings and headaches were improved the least (36). 

The German E Commission has approved St. John s wort for internal consumption for psychogenic disturbances, depressive states, sleep disorders, and anxiety and nervous excitement, particularly that associated with menopause. Oily Hypericum preparations are approved for stomach and gastrointestinal complaints, including diarrhea. Oily Hypericum preparations are also approved by the Commission E for external use for the treatment of incised and contused wounds, muscle aches, and first degree burns (96). 

St. John s Wort (Hypericum perforatum) St. John s wort, known as herbal Prozac, treats depression, anxiety, and psychogenic disturbance similar to monoamine oxidase (MAO). Patients who use St. John s Wort do not have to avoid tyramine-rich foods, which is the case with patients who take MAO. St. John s Wort is a dietary supplement. 

Several studies were also designed to evaluate the antioxidant properties of St. John s Wort (Hypericum perforatum L.), an herbal drug used in the treatment of burns, bruises, swelling and anxiety. Commercially available formulations of St. John s Wort, standardized to the naphthoquinone hypericin, Fig. (13), inhibit free radical production in both cell-free and human vascular tissue [136],... 

State Trait Anxiety Inventory [279] Depression Status Inventory [280] Hypericum extract Placebo... 

A 27-year-old woman who had been taking huspirone 30 mg daily for over one month started to take St John s wort Hypericum 2000 Plus, Herb Valley, Australia) three tablets daily. After 2 months she complained of nervousness, aggression, hyperactivity, insomnia, confusion and disorientation, which was attributed to the serotonin syndrome. The St John s wort was stopped, the huspirone was increased to 50 mg daily and her symptoms resolved over a week. A 42-year-old woman who was taking fluoxetine 20 mg twice daily and huspirone 15 mg twice daily started to develop symptoms of anxiety, with episodes of over-sleeping and memory deficits. It was discovered that she had been self-medicating with St John s wort, ginkgQ biloba and melatonin. She was asked to stop the non-prescribed medication and her symptoms resolved. ... 

Hyperforin. Extracts of St. John s wort (Hypericum perforatum) are licensed in Germany to treat anxiety and sleep and depressive disorders. Clinical trials have demonstrated the activity of the extract. The main anti-depressive principle in H. perforatum seems to be hyperforin, a meroterpene of the humulone type C35H52O4. Mr 536.78, cryst., mp. 79 - 80 C, [a] +41 °... 

The antidepressant activity of hypericum has been extensively investigated over the last two decades in animal models (forced-swimming and tail-suspension tests) as well as in humans. Clinical trials have demonstrated an improvement in symptoms of anxiety, dysphoric mood, hypersomnia, anorexia, depression, insomnia, psychomotor retardation, and other subjective indicators.Potential for the treatment of premenstrual syndrome (PMS) also exists. Earlier studies also showed that hypericum enhanced mice exploratory activity in a foreign environment, extended narcotic sleeping time (dose dependent), is a reserpine antagonist, and decreased aggression in socially isolated male mice. Hypericin has been found to inhibit in vitro almost irreversibly both type A and B monoamine oxidase (MAO) in rat brain mitochondria. Type A MAO (serotonin) inhibition was more pronounced, but with long-term use (8 weeks of daily treatment). Other mechanisms of action, such as serotonin transport and up-... 

---