title: St John's wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT.
abstract: Hypericum perforatum (St John's wort: SJW) has been extensively studied as an antidepressant in short-term trials, however little research has been conducted on longer-term efficacy.Our objective was to analyze the continuation data from a 26-week randomized, double-blind, controlled study of SJW (LI-160) vs. sertraline and placebo in major depressive disorder. 124 participant "responders" continued treatment after week 8, until week 26. They continued randomly assigned SJW (900-1 500 mg), sertraline (50-100 mg) or matching placebo.At week 26, on the primary outcome, Hamilton depression rating scale (HAM-D) completer scores were: SJW (6.6±4.5), sertraline (7.1±5.4) and placebo (5.7±5.4) with a significant effect for time (p=0.036). Comparisons between all treatments were however non-significant (p=0.61). This effect was mirrored on the other outcomes: the BDI, CGI-severity, CGI-improvement, and on intention-to-treat analyses.While the continuation data revealed an equivocal outcome between treatments at week 26, both SJW and sertraline were still therapeutically effective, with a pronounced "placebo-effect" impeding a significant result at week 26.
authors.affiliation: Department of Psychiatry, The University of Melbourne, Melbourne, Australia. jsarris@unimelb.edu.au
authors.forename: J
authors.initials: J
authors.lastname: Sarris
authors.forename: M
authors.initials: M
authors.lastname: Fava
authors.forename: I
authors.initials: I
authors.lastname: Schweitzer
authors.forename: D
authors.initials: D
authors.lastname: Mischoulon
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020902:Hypericum; D008297:Male; D008875:Middle Aged; D010919:Placebos / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D020280:Sertraline / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; C422326:Hypericum extract LI 160; D010919:Placebos; D010936:Plant Extracts; D020280:Sertraline