St. John's Wort Equivalent to Placebo For Treatment of Depression
 
 

CHICAGO, May 17 (Reuters Health) - Patients with depression respond equally well to St. John's wort and placebo, according to study results presented here during the annual meeting of the American Psychiatric Association.

Researchers from Vanderbilt University, Nashville, Tennessee, discussed the results of one of the first large, government-funded projects to look into the effectiveness of St. John's wort. The team, led by Dr. Richard Shelton, conducted an 8-week double-blind study of 200 patients with major depression from 11 university medical centers.

For at least 4 weeks, patients used 900 mg/day of St. John's wort or placebo. If response was inadequate, the dose of St. John's wort was increased to 1,200 mg/day. Few patients discontinued treatment due to side effects from St. John's wort, but the results of interim analysis showed that the herbal preparation was no more effective than placebo.

At the same meeting, Dr. Cornelia Lange of the University of New Mexico, in Albuquerque, discussed a survey conducted at her clinic that showed high rates of herbal therapy use among psychiatric patients. "They're fearful," Dr. Lange said. "They'll try anything they can to avoid coming to a psychiatrist."

Survey responses from 80 patients who had depression, bipolar disorder or schizophrenia showed that 69% were using herbs such as St. John's wort, ginseng, ginkgo biloba, echinacea and chamomile. Similar proportions of Hispanic and non-Hispanic patients reported using herbs. The research also showed that most of the patients said that they hesitated to tell their psychiatrist about their use of herbal remedies.

Herbs may have harmful interactions with conventional antidepressants and other psychiatric drugs, Dr. Lange warned. She advised psychiatrists to be sure to ask their patients, in a nonjudgmental way, whether they are using any herbal supplements.

Dr. Lange counseled her fellow psychiatrists to be approachable and have an open mind so that patients will feel comfortable sharing information about alternative therapies. She also called for more research into interactions between herbs and conventional psychiatric drugs.