Researchers from the US tested St John’s wort alongside a placebo and say the results of their study suggest that the herbal treatment should not be used for “major depression of at least moderate severity”.

They criticize previous studies of St John’s wort that have endorsed the supplement, which they say have failed to characterize specific types of depression that might respond to the herbal treatment.

Writing in the latest edition of the Journal of the American Medical Association, they express concern that people with depression are turning to St John’s wort, also known as Hypericum perforatum, without consulting a physician about their disease.

“Rather than self-medicate with an over-the-counter medication or supplement, patients are strongly advised to consult an appropriate healthcare provider to assess the best treatment for a depressive episode,” says Dr Jonathan Davidson, principal investigator of the study.

The researchers from North Carolina’s Duke University Medical Center used the antidepressant sertraline, a selective serotonin reuptake inhibitor, as a control in the study, which looked at 340 subjects diagnosed with major depression.

The trial involved giving patients a dose three times a day of either a placebo, 900mg to 1,500mg of St John’s wort or 50mg to 100mg of sertraline.

Using the Clinical Global Impressions scale for improvement, sertraline was found to be effective compared to placebo. However, the data showed no benefit of St John’s wort relative to the placebo.

“As long as these types of products remain available to the public without the protection of adequate, controlled and unbiased studies, taking them is like playing Russian roulette with your health,” said Dr Robert Califf, another of the study’s authors.

He warned people with depression to “think twice” about using St. John’s wort until a compound from the medication has “demonstrated efficacy for treating depression”.

A spokesperson for the charity Depression Alliance told Health Media, “St John’s wort is mainly useful in mild to moderate depression. We believe that it can be a very powerful medication which should only be taken in conjunction with medical advice.”

Reference: Hypericum Depression Trial Study Group, JAMA 2002;287:1807-1814

© Health Media Ltd 2002
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