Evidence for...St John's Wort for depression

Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St. John's wort): Randomised controlled double blind non-inferiority trial versus paroxetine.
Szegedi A et al.
BMJ. 2005;330: 503-8.
In 251 patients with moderate to severe major depression, 900 mg/day hypericum extract WS 5570 (St John's wort) three times a day was at least as effective as 20 mg paroxetine once a day for six weeks, and was better tolerated.


A Double-blind, randomized trial of St John's wort, fluoxetine, and placebo in major depressive disorder.
Fava M et al.
J Clin Psychopharmacol. 2005;25:441-7
135 patients with major depressive disorder were randomised to receive 12 weeks' treatment with LI-160 St John's wort extract (900 mg/day), fluoxetine (20 mg/day), or placebo. St John's wort showed significantly better antidepressant efficacy than fluoxetine and showed a trend toward superiority over placebo. (The smaller than planned sample size was thought likely to account for the lack of statistical significance for the advantage of St John's wort over placebo).


Efficacy and tolerability of hypericum extract STW3 in long-term treatment with a once-daily dosage in comparison with sertraline.
Gastpar M et al.
Pharmacopsychiatry. 2005;38:78-86.
A total of 241 patients with moderate depressive disorder were randomised to once-daily doses of either 50 mg of sertraline or 612 mg of hypericum extract STW3, for up to 24 weeks. The treatments showed comparable improvement in 17-item Hamilton Depression Rating Scale total scores, the von Zerssen's Adjective Mood Scale and Clinical Global Impression scale. Hypericum extract STW3 was also well tolerated.