General practitioners and St. John's Wort: a question of regulation or knowledge?
BACKGROUND
St. John's Wort (SJW), also known as Hypericum perforatum, is a herbal remedy available over-the-counter. There is evidence that it can treat mild to moderate depression but has potential side effects and important drug interactions.


OBJECTIVE
To determine general practitioners' (GPs') knowledge and recommendation of SJW for mild to moderate depression within a climate of widespread community use of complementary therapies and debate about regulation.


METHODS
Postal survey of a random sample of 350 Australian GPs.


RESULTS
Forty-eight percent responded. One-third (31%) reported recommending SJW to patients with mild to moderate depression. Of these, only one-third (32%) reported specific dosage instructions. Respondents' knowledge of side effects and interactions was much less than for selective serotonin reuptake inhibitor antidepressants.


CONCLUSIONS
Australian GPs know less about safety of SJW than antidepressants and do not widely recommend it to patients. Despite this, many patients use SJW, probably in combination with other pharmaceuticals. Effective dissemination of further research into effectiveness and risk profiles of complementary therapies is needed to inform health professionals, regulatory bodies and consumers.
McGarry
H
H
Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia. h.mcgarry@unimelb.edu.au
Pirotta
M
M
Hegarty
K
K
Gunn
J
J
D001315:Australia; D003863:Depression / Q000188:drug therapy*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020902:Hypericum; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012720:Severity of Illness Index
D028321:Plant Preparations