St. John's Wort Hypericum perforatum super function.St. John's Wort Extract.
Article Content:
- .Basic Botanical Info of St. John's Wort.
- .St. John's Wort:Origin and Phytochemicals.
- .St. John's Wort and the Treatment of Depression.
- .Why might the U.S. trial have contradicted the European research?
- .Why is St. John's wort used as an alternative therapy for depression?
- .Does St. John's wort work as a treatment for depression?
- .Folklore:St. John's wort.
- .St. John's wort As a Ward.
- .St. John's wort Administrations.
- .Research update of St. John's Wort Hypericum perforatum and hypericin.
St. John's Wort and the Treatment of Depression.
Introduction: The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet on the use of St. John's wort for depression. It is one of a series of fact sheets intended to help consumers make informed decisions about whether to use complementary and alternative medical (CAM) therapies for a disease or medical condition. NCCAM defines CAM practices as those health care and medical practices that are not currently part of conventional medicine. There are many CAM practices. A few examples include traditional Chinese medicine, meditation, chiropractic, therapeutic touch, and herbs.
Key Facts:St. John's wort is an herb that has been used for centuries for medicinal purposes, including to treat depression. The composition of St. John's wort and how it might work are not well understood. There is some scientific evidence that St. John's wort is useful for treating mild to moderate depression. However, recent studies suggest that St. John's wort is of no benefit in treating major depression of moderate severity. More research is required to help us know whether St. John's wort has value in treating other forms of depression. St. John's wort interacts with certain drugs, and these interactions can be dangerous. Herbal products vary greatly as to their chemical composition and quality.
Mode of Action:
St. John's Wort has a wide reputation as an antidepressant.The alkaloid is said to have a tonic effect on the ventricles of the heart, the aorta and arterioles. It is also useful for pulmonary complaints, bladder trouble, suppression of urine, dysentery, worms and nervous depression.
The tranquilizing quality was once attributed to hypericin, but now it is believed to be another constituent or a combination of several. Even small amounts have been found effective, by increasing blood flow to stressed tissue. This blood flow has also been shown to be hypotensive, reduce capillary fragility and to enhance uterine tone. St. John`s wort may cause photosensitivity in a very small group of sensitive individuals.
St John's Wort has antibacterial and antiviral activity against a range of organisms including tuberculosis, Gram positive organisms, Micrococcus, Bacillus, and influenza A/PR8. Tests at the U.S. National Cancer Institute have shown an extract of St. John`s Wort has promise against cancer.
More than a dozen studies, all conducted in Europe, have found that St. John's wort relieves some of the symptoms of mild to moderate depression in about half the people who take it for at least three or four weeks.That's the same success rate as prescription anti-depressants like Prozac, Zoloft, Elavil, and Tofranil. Placebos, on the other hand, appear to help about a quarter of those with depression.
What really sets St. John's wort apart is that the side effects commonly experienced with prescription antidepressants, such as a dry mouth or diminished sex drive, are milder and less frequent with the herb.
After reviewing all the evidence, the American College of Physicians-American Society of Internal Medicine told its 115,000 members last May that St. John's wort "may be effective in treating mild depression in the short term." But that conclusion was reached before the first large U.S. study found that people taking St. John's wort fared no better than those taking a placebo.
The studies of St. John's wort done in Europe, while impressive, left many questions unanswered, says Jacques Bradwejn, Chief of Psychiatry at the Royal Ottawa Hospital in Canada. Among them:
Who benefits? St. John's wort has been studied almost entirely in people with mild to moderate depression. That's a persistent state of sadness, decreased energy, irritability, or other symptoms that interfere with work, sleep, eating, and activities that were once considered pleasurable. (Since depression can lead to suicide, it should be treated by a qualified health professional and not left to self-medication.)
Still unsettled is St. John's wort's effect on moderate to severe depression or on anxiety symptoms. What's more, "there is no evidence that it can elevate mood in people who are not depressed," says psychiatrist Richard Shelton of Vanderbilt University, who conducted the latest U.S. study.
For how long does it work?The European studies lasted an average of only about 5 weeks. Just one exceeded two months. No one knows how long the benefits of St. John's wort last.
How much of which extracts work?The European studies used 300 to 1,800 mg a day of any of 11 different formulations prepared from the St. John's wort flower, so there's no way to tell which brands work consistently in which amounts.
How does it compare with prescription antidepressants?St. John's wort has only been tested against low doses of the older tricyclic antidepressants like Elavil and Tofranil. Researchers don't know how well St. John's wort would do in a head-to-head competition with higher doses or with the newer generation of antidepressants like Prozac or Zoloft.
Given the promising results from the European research, the National Institutes of Health (NIH) has made St. John's wort the subject of the first federally funded, large-scale trial of an herbal supplement in the U.S.
At 12 medical centers across the country, researchers are giving 336 patients with at least moderate depression one of three identical-looking preparations: 900 mg a day of the LI-160 extract of St. John's wort (available as the Kira brand), the prescription antidepressant Zoloft, or a placebo (sugar pill). Those who respond to St. John's wort during the two-month trial will take it for four more months. Results are not expected until next year.
Meanwhile, the first large-scale study of St. John's wort in the U.S. has turned up disappointing results. At Vanderbilt University and ten other medical centers, Richard Shelton and his colleagues gave 200 patients with moderate depression either 900 mg of the LI-160 extract of St. John's wort or a placebo every day for eight weeks. Those who didn't respond to the herb after four weeks were given up to 1,200 mg a day.
After eight weeks, St.John's wort was no better than a sugar pill."Our data suggest that St.John's wort is no more effective than a placebo in patients with at least moderate depression," says Shelton. The study, funded by Pfizer (which makes Zoloft), has not been published yet.
Reference:
1.St. John's Wort Hypericum perforatum super function.St. John's Wort Extract.
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