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St John’s Wort as effective as antidepressantsSt John's Wort is has fewer side effects and has similar efficacy to standard antidepressants in the treatment of major depression, according to the results of a systematic review, newly published in the highly respected Cochrane Database of Systematic Review. The authors analysed a total of 29 randomised, double-blind trials (RCT). RCTs are considered the strongest evidence of a link between treatment and effect; they involve randomly assigning each participant either to an active treatment or identical inactive treatment (placebo), neither the participants nor the researchers should be aware which treatment each person is taking. The 29 studies involved a total of 5,489 patients with major depression; 18 of the trials compared St John's Wort with placebo, 17 compared St John's Wort with standard antidepressants. The authors concluded: "The available evidence suggests that the hypericum extracts [St John's Wort] tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants." Click here to view the study abstract. These results will not come as a surprise in Germany, where St John's Wort is used extensively. The herb contains several natural chemicals, including hypericin, hyperforin and flavonoids. Researchers aren't exactly sure how St. John'sWort works, although it has been suggested that the herb acts like conventional antidepressants, making more of the neurotransmitters serotonin, dopamine and adrenaline available to the brain; these neurotransmitters regulate mood. Unlike standard antidepressants side effects from St. John'swort are rare and mild, they can include stomach upset, hives, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. St. John's wort can also make the skin overly sensitive to sunlight (called photodermatitis). For the management of depression a dose of 300mg standardized to 0.3% hypericin three times daily is suggested (may be standardized to 2-5% hyperforin as well). St John's Wort is not a cure for depression, it is vital to seek professional advice on the overall management of the condition. |