Hypericum

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In complementary and alternative medicine, specifically phytotherapy (i.e., herbal medicine) hypericum, also called St John's wort may have medicinal purposes.

Pharmacology

A component of hypericum, hyperforin, may act as a serotonin uptake inhibitor.[1] Taking hypericum with conventional selective serotonin uptake inhibitors (i.e., second-generation antidepressants, which also increase serotonin levels, have resulted in the complication of serotonin syndrome. It may, however, be lower in cardiac risk than some tricyclic antidepressants such as imipramine. There are also potential interactions with oral contraceptives, digoxin, warfarin, cyclosporin or indinavir.[2]

Clinical purposes

Hypericum may help treat mild depression.[3]

One randomized controlled trial found no benefit from a daily dose of up to 1500 mg[4], whereas a subsequent trial using 300 mg three times a day found benefit[5] and a subsequent trial using a higher dose of hypericum (900 mg/day hypericum extract three times a day) found benefit[6].

References

  1. Schulte-Löbbert S, Holoubek G, Müller WE, Schubert-Zsilavecz M, Wurglics M (2004). "Comparison of the synaptosomal uptake inhibition of serotonin by St John's wort products.". J Pharm Pharmacol 56 (6): 813-8. DOI:10.1211/0022357023493. PMID 15231048. Research Blogging.
  2. Rick Marinelli, Hypericum Perforatum: An Update in Pain Management, American Academy of Pain Management
  3. Geddes J, Butler R, Hatcher S, Cipriani A, Price J, Carney S et al. (2006). "Depression in adults.". Clin Evid (15): 1366-406. PMID 16973054[e]
  4. Hypericum Depression Trial Study Group (2002). "Effect of Hypericum perforatum (St John's wort) in major depressive disorder: a randomized controlled trial.". JAMA 287 (14): 1807-14. PMID 11939866[e] Review in: Evid Based Ment Health. 2002 Nov;5(4):111
  5. Lecrubier Y, Clerc G, Didi R, Kieser M (2002). "Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial.". Am J Psychiatry 159 (8): 1361-6. PMID 12153829[e]
  6. Szegedi A, Kohnen R, Dienel A, Kieser M (2005). "Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine.". BMJ 330 (7490): 503. DOI:10.1136/bmj.38356.655266.82. PMID 15708844. PMC PMC552808. Research Blogging. Review in: Evid Based Ment Health. 2005 Nov;8(4):107