Efficacy and safety of St. John's wort for the treatment of major depression.
OBJECTIVE
Extracts of St. John's wort have been widely used in the treatment of depression. Our aim was to review information related to the efficacy and safety of St. John's wort as an antidepressant.


METHODS
Primary and review articles were identified by a search of Medline (1960 to February 2000) and through secondary sources.


METHODS
All the articles identified from the data sources were evaluated and all relevant information was included in this review. The pharmacokinetics, mechanism of action, efficacy, side effects and drug interactions of St. John's wort have been examined in various studies.


CONCLUSIONS
St. John's wort is a promising investigational antidepressant, but the data are not yet sufficient to accept hypericum as a first line antidepressant preparation for treatment of depression. Besides the need for dose standardization and adequate trial lengths, there is a need for studies in severely depressed patients and long-term studies to assess the risk of relapse and recurrence.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
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Nangia
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Syed
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Doraiswamy
D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004347:Drug Interactions; D006801:Humans; D020902:Hypericum / Q000009:adverse effects / Q000627:therapeutic use*; D016239:MEDLINE; D008517:Phytotherapy; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use; D010946:Plants, Medicinal; D012449:Safety; D016896:Treatment Outcome
D000928:Antidepressive Agents; D010936:Plant Extracts