Study 6

Treatment of mild to moderate depressions with hypericum

AU: Sommer-H; Harrer-G

AD: Psychiatrische Fachpraxis, Universitat Salzburg, Austria.

SO: Phytomedicine Vol. 1/1994, pp 3-8

Description

• In a multicenter randomized double-blind trial, 105 patients aged 20-65 years were given either Jarsin 300 containing 0.9 mg hypericin x 3 or a placebo for four weeks.
• Entrance criteria were neurotic depression (ICD 09 300.4), and brief depressive reaction (ICD 09 309.0).
• All other medical treatments were recorded in order to investigate possible interactions.

Results

• Of the 105 patients included in the study, 9 stopped treatment. Four of them (2 from the trial group and 2 from the placebo group) did not give any reason; 4 from the placebo group stopped because of inefficacy, and one patient in the placebo group stopped because of "undesired side-effects"! Seven patients were excluded before the study started because they no longer fulfilled the inclusion criteria. At the end there were 42 patients in the treatment group and 47 in the placebo group.
• The mean HAMD fell from 15.8 at the beginning to 7.2 at the end in the hypericum group and from 15.8 to 11.3 in the placebo group. The difference was statistically significant with a p< 0.01.
• 67% of the patients in the hypericum group were classified as responders, compared to 28% in the placebo group.
• There were impressive improvements concerning depressive mood, difficulty in falling asleep, emotional fear, and psychosomatic symptoms (disturbed sleep, headache, cardiac troubles, exhaustion), but not for feelings of guilt, difficulty in sleeping through and somatic fear in the hypericum group.
• 2 patients in the hypericum group (skin reddening, tiredness) and 3 patients in the placebo group (increased sleep requirement, mild abdominal pains, edema, psychological vulnerability, increase in weight and indecisiveness) experienced adverse drug effects.
• Compliance was good, except for one patient.
• There were no signs of interactions with other pharmaceutical agents.

Researchers' comments

• Dr. Sommer and Harrer emphasize the good compliance with hypericum compared to synthetic antidepressants, which makes it "the remedy of choice" for the treatment of mild to moderate depressions.
• They do not recommend hypericum for the treatment of severe depressions, i.e., depressions with suicide risk, psychotic symptoms (delusions, hallucinations) or when the depression seriously disturbs normal work and family life. They unfortunately do not elaborate.

Our comments

• One of many similar studies of the same kind, with very typical results.
• It is interesting to note that ADRs were more common in the placebo group than in the hypericum group. One reason for this could be more somatoform depressive symptoms because of less antidepressant effect.