04-14-2002, 03:47 AM #1
article I just read on st johns wart
St. John's Wort Not Effective -- Again
Second Trial Shows Herb Doesn't Work in Major Depression
April 9, 2002 -- St. John's Wort doesn't help people with major depression.
It didn't help in a clinical trial reported last year. And it didn't help in a new clinical trial reported in the April 10 issue of The Journal of the American Medical Association.
Study leader Jonathan R.T. Davidson, MD, is professor of psychiatry and director of the anxiety and traumatic stress program at Duke University in Durham, N.C. He notes that though several earlier studies found that St. John's wort had an antidepressant effect, the two most comprehensive studies fail to find any true benefit.
"If you have moderate or major depression, you are much better off getting treatment with an established therapy than with St. John's wort," Davidson tells WebMD.
So is this the end for the curiously named and popular herb?
"Where St. John's wort belongs, we still are unsure," Davidson says. "It might be useful for more minor cases of depression. But would people continue to take it instead of getting more effective help for their condition? I suppose if it were used for brief and mild periods of sadness, that would be OK. There's not much data there."
Psychiatrist Mark I. Levy, MD, worries that the main danger to patients who use St. John's wort is undertreated depression. Levy sees patients in private practice and teaches psychiatry at the University of California, San Francisco.
"I don't think the danger is a direct effect of using St. John's wort -- the issue is its lack of efficacy," Levy tells WebMD. "The danger is the illusion of effect, given that untreated depression has a 15% death rate. If people think they are going to treat it by taking a relatively ineffective medication, that scares me."
St. John's wort -- also known as hypericum -- isn't a harmless herb. It does have side effects, but its main danger is that it interferes with other medicines a person may be taking. It's a long list -- maybe as many as half of all drugs -- including many on which patients' lives depend. These medicines include drugs for HIV infection, heart disease, seizure, and cancer. People taking any of these medications are advised to consult their doctors before using any products containing St. John's wort (hypericum) or the active ingredient, hypericin.
Davidson's team -- the Hypericum Depression Trial Study Group at 12 U.S. research centers -- enrolled 340 patients with major depression. They received one of three treatments: St. John's wort extract; the antidepressant Zoloft; or sugar pills. Neither the patients nor their doctors knew which drug they were getting.
Depression was fully or partially relieved in 38.1% of St. John's wort patients, in 43.1% of patients getting sugar pills, and in 48.6% of patients getting Zoloft. It is not uncommon for patients in clinical trials of depression to do better even if they only get fake treatment. This may explain some of the antidepressant effect previously attributed to St. John's wort. But it may better explain why drugs aren't the only useful treatment for depression.
"People who are depressed respond to human interventions whether or not this involves the dispensing of medication," Levy says. "Psychotherapy is useful and helpful for many people. The majority of people I see get better sooner with antidepressants. And a lot of people will get a lot better by adding psychotherapy to medication."
I hope it is of some use ,,,Taken from the web
04-14-2002, 06:21 PM #2
nice post bro
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