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Advances in Therapy

, Volume 19, Issue 1, pp 43–52 | Cite as

Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression

  • Kirsten Behnke
  • Gert Saaby Jensen
  • Hans-Joachim Graubaum
  • Joerg Gruenwald
Article

Abstract

In a randomized, controlled, double-blind trial, 70 patients (mean age, 49.7 years) suffering from mild to moderate depression received one tablet of either St. John’s Wort (Hypericum perforatum) extract (Calmigen®) or fluoxetine hydrochloride (Prozac®) twice a day for 6 weeks. Efficacy was determined according to the 17-item Hamilton Rating Scale for Depression (HAMD), the von Zerssen depression scale (DS), Clinical Global Impression (CGI), and patients’ overall evaluation. Significant decreases (P<.001) of 50% in theHypericum group and 58% in the fluoxetine group in the HAMD score and of 42% and 52% on the DS spoke to the efficacy of both medications. TheHypericum extract achieved 83% of the efficacy of fluoxetine on the HAMD and 78% on the DS. Assessments by physicians (CGI) and patients indicated considerable improvement with no between-treatment differences. Of the 9 dropouts (13%), 2 in theHypericum group and 2 in the fluoxetine group were due to adverse reactions. Safety evaluations demonstrated only minor changes. TheHypericum preparation tested in this study is therapeutically equivalent to fluoxetine and is therefore a rational alternative to synthetic antidepressants.

Keywords

Hypericum perforatum St. John’s Wort herbal product fluoxetine drug therapy depression 

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References

  1. 1.
    Harrer G.Hypericum: Pflanzliches Antidepressivum für Nervenarzt und Hausarzt.Nervenheilk. 1991;10:3.Google Scholar
  2. 2.
    Stein M. Gegen Depressionen ist ein Kraut gewachsen.Dtsch Apoth Ztg. 1995;135:4416–4417.Google Scholar
  3. 3.
    Faust V. Psychotrope phytopharmaka—Möglichkeiten und Grenzen.Select/Med Akt. 1996;29:20.Google Scholar
  4. 4.
    Sommer H. Besserung psychovegetativer Beschwerden durch Hypericum im Rahmen einer multizentrischen Doppelblindstudie.Nervenheilk. 1991;10:308–310.Google Scholar
  5. 5.
    International Classification of Diseases. 10th ed. Geneva: WHO; 1991.Google Scholar
  6. 6.
    Schakau D, Hiller K-O, Schultz-Zehden W, Teschner F. Nutzen/Risiko-Profil von Johanniskrautextrakt.Psychopharmakotherapie. 1996;3:116–122.Google Scholar
  7. 7.
    Diagnostic and Statistical Manual of Mental Disorders. 3rd ed, rev. Washington, DC: American Psychiatric Association; 1982.Google Scholar
  8. 8.
    Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1995.Google Scholar
  9. 9.
    Hippius H. St. John’s wort (Hypericum perforatum)—A herbal antidepressant.Curr Med Res Opin. 1998;14:171–184.PubMedCrossRefGoogle Scholar
  10. 10.
    Albrecht M, Hübner W-D, Podzuweit H, Schmidt U. Johanniskraut-Extrakt zur Behandlung der Depression.Kassenarzt. 1994;41:45–54.Google Scholar
  11. 11.
    Borchers HG. Ist Phytotherapie eine sinnvolle Alternative bei der Behandlung der Depression?Schweiz Z Ganzheitsmed. 1994;3:116–117.Google Scholar
  12. 12.
    Becker SR. Das Johanniskraut (Hypericum perforatum)—Antidepressivum aus der Natur.Schweiz Z Ganzheitsmed. 1994;2:92–94.Google Scholar
  13. 13.
    Gaster B, Holroyd J. St John’s wort for depression—A systematic review.Arch Intern Med. 2000; 160:152–156.PubMedCrossRefGoogle Scholar
  14. 14.
    Drug Commission (Arzneimittelkommission). Vorinformation: Johanniskraut-haltige Humanarzneimittel zur innerlichen Anwendung.Pharmazeut Ztg. 2000;145/14:1077, 1153–1154.Google Scholar
  15. 15.
    Gruenwald J. St John’s wort—The international debate.Nutraceut World. 2001;6:26–27.Google Scholar
  16. 16.
    Müller WE, Schäfer C, Rolli M, Wonnemann R. Effects ofHypericum extract Li 160 on neurotransmitter uptake systems and β-adrenergic receptor density.Phytomedicine. 1996;Suppl 1:100.Google Scholar
  17. 17.
    Harrer G. Die Angst vor dem “Psychohammer.”Therapiewoche. 1991;41:3092–3098.Google Scholar
  18. 18.
    Saller R, Reichling J, Kristof O. Phytotherapie—Behandlung ohne Nebenwirkungen?Dtsch Med Wochenschr. 1998;123:58–52.PubMedGoogle Scholar
  19. 19.
    Habs M, Honold E. Der psychoaktive Spezialextrakt WS 1490 aus dem Wurzelstock vonPiper methysticum (kava-kava)—ein Report.Forsch Komplementärmed. 1994;1:208–215.Google Scholar
  20. 20.
    Beaubrun G, Gray GE. A review of herbal medicines for psychiatric disorders.Psychiatr Serv. 2000;51/9:1130–1134.PubMedCrossRefGoogle Scholar
  21. 21.
    Schmidt U, Harrer G, Kuhn U, Biller A. Äquivalenzvergleich Johanniskrautextrakt LoHyp-57 versus Fluoxetin-HCL. Presented at the ESCOP Conference; October 1998; London, England.Google Scholar
  22. 22.
    Schrader E. Equivalence of St John’s Wort extract (Ze 117) and fluoxetine: a randomised, controlled study in mild-moderate depression.Int Clin Psychopharmacol. 2000;15:61–68.PubMedCrossRefGoogle Scholar
  23. 23.
    Schrader E, Meier B, Brattström A.Hypericum treatment of mild-moderate depression in a placebo-controlled study. A prospective, double-blind, randomised, multicentre study.Hum Psychopharmacol. 1998;13:163–169.CrossRefGoogle Scholar
  24. 24.
    Woelk H. Comparison of St John’s Wort and imipramine for treating depression: a randomised controlled trial.BMJ. 2000;321:536–539.PubMedCrossRefGoogle Scholar
  25. 25.
    Halama P. Wirksamkeit des Johanniskrautextraktes Li 160 bei depressiver Verstimmung.Nervenheilk. 1991;10:305–307.Google Scholar
  26. 26.
    Harrer G, Sommer H. Therapie leichter/mittelschwerer Depressionen mitHypericum.Münch Med Wochenschr. 1993;135:305–309.Google Scholar
  27. 27.
    Lehrl S, Willemsen A, Papp R, Woelk H. Ergebnisse von Messungen der kognitiven Leistungsfähigkeit bei Patienten unter der Therapie mit Johanniskrautextrakt.Nervenheilk. 1993;12:281–284.Google Scholar
  28. 28.
    Reh C, Laux P, Schenk N.Hypericum-Extrakt bei Depressionen—eine wirksame Alternative.Therapiewoche. 1992;42:1576–1581.Google Scholar
  29. 29.
    Volz HP, Laux P. Potential treatment for subthreshold and mild depression: a comparison of St. John’s Wort extracts and fluoxetine.Compr Psychiatry. 2000;41:133–137.PubMedCrossRefGoogle Scholar
  30. 30.
    Maisenbacher H-J, Kuhn U. Therapie von Depressionen in der Praxis—Ergebnisse einer Anwendungsbeobachtung mit Herba Hyperici.Naturamed. 1992;7:394–399.Google Scholar

Copyright information

© Health Communications Inc 2002

Authors and Affiliations

  • Kirsten Behnke
    • 1
  • Gert Saaby Jensen
    • 2
  • Hans-Joachim Graubaum
    • 3
  • Joerg Gruenwald
    • 3
  1. 1.FrederiksbergDenmark
  2. 2.RødovreDenmark
  3. 3.PhytoPharm ConsultingInstitute for PhytopharmaceuticalsBerlinGermany

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