This article is from Psychiatry.
Herbal extract shows comparable efficacy to common antidepressant
11 Feb 2005
Hypericum extract WS 5570, also known as St John's Wort, appears to be as effective as the selective serotonin reuptake inhibitor paroxetine for the treatment of moderate-to-severe depression, researchers report.
The team, led by A Szegedi from Charité-Universitätsmedizin Berlin in Germany and colleagues compared the treatment benefits of hypericum extract and paroxetine in 251 patients aged between 18 and 70 years with acute major depression. All the participants had a Hamilton Depression Rating Scale score of 22 or above.
The patients were randomly assigned to receive either 900 mg/day of hypericum extract WS 5570 three times a day or 20 mg of paroxetine once a day for 6 weeks. Among those who did not initially respond to treatment, the doses of hypericum and risperidone were increased to 1800 mg/day and 50 mg/day, respectively.
Scores on the HAM-D scale decreased by an average of 14.4 points in patients taking hypericum extract and by an average of 11.4 points among those given paroxetine.
Moreover, at the end of treatment, 71% of patients taking hypericum extract were considered to have responded to treatment, defined as a 50% or greater decrease in score on the HAM-D scale, compared with 60% of paroxetine-treated patients. The respective remission rates were 50% and 35%.
Compared with paroxetine, hypericum extract was also associated with a superior tolerability profile, with paroxetine-treated patients suffering 269 adverse effects, while those given hypericum extract experienced 172 unwanted effects. Stomach disorders were the most common effects reported in both cases.
"We have shown that hypericum extract WS 5570 is at least as effective as paroxetine over 6 weeks of acute treatment in outpatients with moderate or severe unipolar major depression," the researchers write in an early online issue of the British Medical Journal.
They are now assessing the long-term efficacy of the hypericum extract, for which the team says the drug could be an interesting option, "because of its favorable ratio between efficacy and tolerability in the ongoing continuation phase."
Source: BMJ 2005; Early online publicationExternal Link
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