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St John's wort and duration of effect on depression.

Singer A, Schmidt M, Haukea W, Stade K. 2011. Duration of response after treatment of mild to moderate depression with Hypericum extract STW 3-VI, citalopram and placebo: A reanalysis of data from a controlled clinical trial. Phytomed 18;739-42.

Major depression is one of the world's most common disorders, especially in western or industrialised countries. The high risk of disability and death, and tendency for relapse make it imperative that we find effective long term ways of treating this condition. Studies have shown St John's wort (SJW) to be an effective and safe treatment for mild to major depression. This paper is a reanalysis of a study which demonstrated the efficacy of SJW in moderate depression and the non inferiority of this product compared with citalopram.

Out of 394 patients in the trial, 188 were responders to medication and 154 we re-evaluated after one, two and three years (following initial treatment) for the duration of response to medication and the possible occurrence of relapse. Of these 154, 30 had a relapse within the first half year after treatment and relapse rate was highest in those who had responded to citalopram and lowest in the SJW responders. In accordance with this, relapse rates continued to be lower in the patients treated herbally after 1, 2 and 3 years. Median time to occurrence of a relapse and/or recurrence was 802 days for the placebo group, 1755 days for the citalopram group and 1817 days for the group of Hypericum responders.

This data indicates that not only is SJW similarly effective to citralopram in inducing remission from depression, it is also more effective at preventing relapse after the treatment period. This may suggest that it is potentially a better treatment for responders as it may somewhat lower the risk of relapse.

Tessa Finney-Brown MNHAA

tessafinneybrown@gmail.com

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Author:Finney-Brown, Tessa
Publication:Australian Journal of Medical Herbalism
Article Type:Brief article
Date:Dec 22, 2011
Words:305
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