St John's wort for depression: Meta-analysis of randomised controlled trials

Extracts of Hypericum perforatum (St John's wort) are widely used to treat depression. Evidence for its efficacy has been criticised on methodological grounds. To update evidence from randomised trials regarding the effectiveness of Hypericum extracts. We performed a systematic review and meta-...

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Bibliographic Details
Published in:British journal of psychiatry 2005-02, Vol.186 (2), p.99-107
Main Authors: LINDE, KLAUS, BERNER, MICHAEL, EGGER, MATTHIAS, MULROW, CYNTHIA
Format: Article
Language:English
Subjects:
Antidepressants
Antidepressive Agents - therapeutic use
Clinical trials
Collaboration
Depression
Depressive Disorder - drug therapy
Drug dosages
Efficacy
Germany
Humans
Hypericum
Mental depression
Mental disorders
Meta-analysis
Patients
Physicians
Phytotherapy - methods
Plant Extracts - therapeutic use
Primary care
Psychiatry
Quality
Randomized controlled trials
Randomized Controlled Trials as Topic
Ratios
Software
St John's wort
Studies
Systematic review
Treatment
Treatment Outcome
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Description
Summary:Extracts of Hypericum perforatum (St John's wort) are widely used to treat depression. Evidence for its efficacy has been criticised on methodological grounds. To update evidence from randomised trials regarding the effectiveness of Hypericum extracts. We performed a systematic review and meta-analysis of 37 double-blind randomised controlled trials that compared clinical effects of Hypericum monopreparation with either placebo or a standard antidepressant in adults with depressive disorders. Larger placebo-controlled trials restricted to patients with major depression showed only minor effects over placebo, while older and smaller trials not restricted to patients with major depression showed marked effects. Compared with standard antidepressants Hypericum extracts had similar effects. Current evidence regarding Hypericum extracts is inconsistent and confusing. In patients who meet criteria for major depression, several recent placebo-controlled trials suggest that Hypericum has minimal beneficial effects while other trials suggest that Hypericum and standard antidepressants have similar beneficial effects.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.186.2.99