Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression: a randomized double-blind trial in a Brazilian sample.
OBJECTIVE
Hypericum perforatum has demonstrated antidepressant efficacy when compared to placebo, but comparisons with other antidepressants remain controversial. We assessed the efficacy and safety of Hypericum perforatum in comparison with fluoxetine, in a 8-week double-blind trial in patients with mild to moderate depression.


METHODS
Seventy-two outpatients were randomly assigned to receive Hypericum perforatum 900 mg/day, fluoxetine 20 mg/day or placebo. Efficacy measures included the HAM-D21 scale, the Montgomery-Asberg Rating Scale, and the Clinical Global Impression. Safety was assessed with the UKU Side Effect Rating Scale.


RESULTS
Intention-to-treat analysis showed no differences between the mean scores of the three groups. In the analyses of observed cases, patients receiving Hypericum perforatum had the lowest remission rates (12%, p = 0.016) compared to fluoxetine (34.6%) and placebo (45%).


CONCLUSIONS
Hypericum perforatum was less efficacious than both fluoxetine and placebo. Both drugs were safe and well-tolerated. Larger trials are needed for definite conclusions.
Moreno
Ricardo Alberto
RA
Institute of Psychiatry, Clinical Hospital, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil. rmoreno@sti.com.br
Teng
Chei Tung
CT
Almeida
Karla Mathias de
KM
Tavares Junior
Hildeberto
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001938:Brazil; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D020902:Hypericum; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D015990:Placebo Effect; D010936:Plant Extracts / Q000627:therapeutic use; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D010936:Plant Extracts; D005473:Fluoxetine