Depression hypericum

A number of studies have suggested St. John s wort as a viable treatment for depression. In one study of more than 3,000 patients with mild to moderate depression, over three quarters showed improvement after four weeks of using the herb. In another study, patients who received St. John s wort showed significantly more improvement than patients who received a placebo. Although St. John s wort may provide benefits to individuals with milder forms of depression (Lawvere Mahoney, 2005), recent studies have indicated that it is not effective in the treatment of major depression (Hypericum Depression Trial Study Group, 2002 Shelton et al., 2001). 

Along with depression, hypericum has been studied in SAD. There have been two studies in which participants received 300 mg St. John s wort three times daily with or without bright-light therapy either for 4 or 8 weeks. In... 

Arif Khan, Nick Redding and Walter A. Brown, 2008. Hypericum Depression Trial Study Group, 2002. 

Hudson, Christopher G., Socioeconomic Status and Mental Illness Tests of the Social Causation and Selection Hypotheses , American Journal of Orthopsychiatry 75, no. 1 (2005) 3-18 The Humble Humbug , The Lancet 2 (1954) 321 Hunter, Aimee M., Andrew F. Leuchter, Melinda L. Morgan and Ian A. Cook, Changes in Brain Function (Quantitative EEG Cordance) During Placebo Lead-in and Treatment Outcomes in Clinical Trials for Major Depression , American Journal of Psychiatry 163, no. 8 (2006) 1426-32 Hyland, Michael E., Do Person Variables Exist in Different Ways , American Psychologist 40 (1985) 1003-10 Hypericum Depression Trial Study Group, Effect of Hypericum Perforatum (St John s Wort) in Major Depressive Disorder A Randomized Controlled Trial , Journal of the American Medical Association 287 (2002) 1807-14... 

Philipp, Michael, Ralf Kohnen and Karl O. Hiller, Hypericum Extract Versus Imipramine or Placebo in Patients with Moderate Depression Randomised Multicentre Study ofTreatment for Eight Weeks , British Medical Journal 319 (1999) 1534-39... 

Hypericum An extract of Hypericum perforatum (St John s wort) used in the phytotherapy of depression. 

Opioid A recent study has shown activity of hypericum extracts at opioid receptors (Simmen et al. 1998). Extracts displace naloxone from p and x opioid receptors in the micromolar range (IC50 25 and 90 pg/ml, respectively). In contrast, extracts of the sedative herb Valeriana officinalis do not have this effect. This effect is due to unidentified constituents and not by the flavonoids quercetin or kaemferol. Opioids are known to have effects on emotion, so it is conceivable that activity of hypericum at p and k receptors contributes to its therapeutic effects (Gerra et al. 1998 Tejedor-Real et al. 1995 Walker and Zacny 1998). Although they are not conventional treatment for depression, opioids such as buprenorphine have been effective in treatment of refractory depression (Bodkin et a. 1995). However, for any further conclusions to be drawn, it would be necessary to further e uddate the opioid effects of hypericum to determine what functional effect, if any, hypericum has on the receptors. 

Hypericum also has effects on cytokine levels (Thiele et al. 1994). A hypericum extract (LI 160) given to people with depression and healthy... 

Hypomania and use with other antidepressants One case has been reported of concurrent use of hypericum with an SSRI. Gordon (1998) reported a case of a 50-year-old woman taking 600 mg/day of hypericum for chronic depression. She had discontinued taking Paxil 10 days prior to hypericum and experienced no ill effects at that time. However, she added 20 mg of paroxetine to her regimen of hypericum to improve her sleep. She presented with lethargy, nausea, and weakness, but vital signs and mental status were normal. Following discontinuation of medications, she returned to normal status the next day. 

Thus, the long tradition of hypericum as a treatment for depression has been well supported by modern scientific research. Several active constituents have been identified, including naphthodianthrones (e.g., hypericin), phloroglucinols (e.g., hyperforin) and flavonoids (amentoflavone). Research has delineated its pharmacokinetic properties, and many of its neurochemical mechanisms have been identified enhancing monoamine... 

Future directions for research on hypericum may continue the work done in clinical efficacy. More specifically, studies may be of interest that examine its effects in treatment of more severe depression and different subtypes of depression. The comparative efficacy of different hypericum preparations could be further investigated, and optimum dosages need to be established (Linde et al. 1996). Further work is needed to compare hypericum s efficacy and side effects with those of the SSRIs or atypical antidepressants, because published studies to date have only compared it with tricyclics. 

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. 

Hubner WD, Lande S, Podzuweit H. (1994). Hypericum treatment of mild depressions with somatic symptoms. J Geriatr Psychiatry Neurol. 7(suppl 1) S12-4. 

Volz HP. (1997). Controlled clinical trials of hypericum extracts in depressed patients—an overview. Pharmacopsychiatry. 30(suppl 2) 72-6. 

Several natural products have been evaluated in rodent models of nicotine withdrawal. An extract of Hypericum perforatum (St. John s Wort, a putative antidepressant, and inhibitor of serotonin reuptake) reversed somatically expressed withdrawal behaviors and locomotor depression in spontaneous withdrawal (Catania et al. 2003). A benzoflavone compound isolated from Passiflora incarnata, interfered with the induction of physical dependence. Coadministration with chronic nicotine prevented various subsequent indicators of withdrawal syndrome in the mouse, including jumping, locomotor inactivity, immobility in the swim test and naloxone-precipitated escape jumping (Dhawan et al. 2002). 

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

St John s Wort (Hypericum perforatum, S JW) has been on the herbal pharmacopeia for many years. It is a traditional remedy for depression which has been validated in recent randomized clinical trials. Like many herbal preparations levels of active constituents vary from one preparation to another. As a consequence of its validation as an active preparation it has been widely promoted. Recently it has been shown to interact with a variety of other substances probably through the process of drug interaction. 

Hypericum perforatum, more commonly known as Hypericum or St. John s wort, is used widely because of the perception that it is a safer, natural antidepressant. In Germany, Hypericum is used more extensively than conventional antidepressants for treating depression. Because St. John s wort has been attracting increasing media attention worldwide, consumption of this herb is likely to become more prevalent. 

In summary, there is evidence that Hypericum is effective in the treatment of adults with depression of mild to moderate severity. It appears also that patients tolerate St. John s wort well. Nevertheless, there are no reports involving children and adolescents. Until such data become available it cannot be concluded whether St. John s wort is effective in this age group. 

There is no empirical evidence available for clinical use in children and adolescents. Yet, Hypericum seems to be used for the treatment of mild to moderate depression in the young (Walter et ah, 2000). St. John s wort should be avoided in young patients with severe depression and bipolar disorder (given the lack of adult data about effectiveness and risk of manic induction, respectively) and in those who have significant suicide risk. Treatments of proven efficacy (e.g., SSRIs, mood stabilisers) should be preferred in these cases. However, St. John s wort may be considered in cases of unipolar depression where conventional treatments have failed and prior to the use of combinations of drugs that have an increased risk of side effects and whose efficacy has not been demonstrated. 

St. John s wort is available as tablets, capsules, drops, and teas. Many brands exist and Hypericum is widely available in health food stores or through the Internet. There is an oil form for external use but this has no place in treating depression. Many St. John s wort preparations have other ingredients and should be avoided. 

Comparison of an extract of Hypericum (LI 160) and serttaline in the treatment of depression a double-blind randomized pilot study. Clin Ther 22 411—419. 

Hypericum Depression Trial Study Group Effect of Hypericum perforatum (St John s wort) in major depresssive disorder. J. Am. Med. Assoc. 287, 1807-1814. 2002. 

A number of studies have been performed on the efficacy of St. John s Wort as an antidepressant. Several meta-analyses of these studies have also been published. The first such metaanalysis involved 23 randomized trials (15 placebo-controlled and eight active-controlled) involving 1,757 outpatients. It concluded that there was preliminary evidence supporting hypericum extracts as being superior to placebo in patients with mild to moderate clinical depression ( 233). Two more recent reviews of subsequent, placebo-controlled studies also concluded that hypericum is more effective than placebo but possibly less effective than TCAs ( 234, 235). At least two large-scale, multicenter, double-blind, placebo- and active-controlled studies are ongoing in the United States, testing the efficacy of hypericum versus an SSRI in patients with major depression. The results of these studies should further clarify the role of hypericum in the treatment of depressive disorders. 

Stevinson C, Ernst E. Hypericum for depression. An update of the clinical evidence. Eur Neuropsychopharmacot 2000 9 501-505. 

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). 

Behnke K, Jensen GS, Graubaum HJ, Gruenwald J. Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression. Adv Ther 2002 19(l) 43-52. 

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