Study 2

Treatment of mild to moderate depressions: A comparison between Hypericum perforatum and Amitryptiline

AU: Bergmann-R, Nuessner-J, Demling-J

SO: Neurologie/Psychiatrie 7, 235-240, vol 4 April 1993

Description

80 patients were treated in a randomized double-blind study for 6 weeks with Esbericum capsules containing 0.25 mg hypericin x 3 or Amitryptilin 10 mg x 3 ( a synthetic antidepressant).

• Entrance criteria were mild and moderate depressive syndromes (ICD-10 F32.0 + F32.1) and recurrent depressive episodes of mild to moderate severity (ICD-10 F33.0 + F33.1).
• The patients were also questioned about daily sleep length and dream content.
• Side effect were asked for and recorded.

Results

HAMD

• The mean HAMD fell from 15.82 to 6.34 in the hypericum group and from 15.26 to 6.86 in the Amitryptiline group.
• The mean HAMD was improved by 60% in the treatment group and 56% in the control group.
• The difference was not statistically significant.

Bf-S

• The mean Bf-s was reduced from 31.45 to 24.22 in the hypericum group and from 28.21 to 24.13 in the control group.
• The difference was not statistically significant.

Dreams and sleep

• Daily sleep amount increased in the hypericum group from 5.60 hours to 6.58 hours and in the Amitryptiline group from 5.51 to 6.73 hours.
• There were no differences observed in quality or quantity of dreams reported between the two groups.
• The amount of anxiety-colored dreams diminished in both groups significantly.

Side effects

• 58% of the patients in the Amitryptiline group complained about tiredness (16 remarks), dry mouth (13 remarks), pressure in the stomach (10 remarks) and a few others about gastrointestinal and respiratory complaints.
• 24% complained about pressure in the stomach, gastric pains and tiredness in the hypericum group.

Dropouts

• 2 persons discontinued the medication in the hypericum group because of gastrointestinal complaints. One of them was given an Amitryptiline preparation after dropping out, which also gave the same problems.
• 2 persons discontinued the study in the Amitryptiline group, reasons were GI symptoms, tiredness and hypomania.

Researchers' comments

The authors noted that placebo-treatment has been found less effective in severe depressions than in mild to moderate depressions.

They suspected that the gastrointestinal complaints in the hypericum group might be more because of the depression than because of side effects from hypericum.