A spate of national publicity has pushed St. John’s wort (Hypericum perforatum) into position as the most popular medicinal herb in the United States. A feature article in the May 5, 1997, issue of Newsweek was followed by a television segment airing June 27, 1997, on ABC’s 20/20. Sales of St. John’s wort products increased so dramatically after the 20/20 report that the products are now in short supply.
In Germany, St. John’s wort already outsells the antidepressant Prozac twenty to one, and some medical analysts have predicted that the herb could become the most widely used antidepressant in the United States within two years.
Much of the current media interest in St. John’s wort stems from a 1996 British Medical Journal report analyzing the results of twenty-three randomized clinical trials involving 1,757 outpatients diagnosed with mild to moderate depression. In fifteen studies, fourteen using St. John’s wort alone and one using a combination product, St. John’s wort was compared with a placebo. Eight trials compared the herb with standard antidepressant drugs. Six of these used St.-John’s-wort alone, and two used a combination product. Overall, side effects were reported in 19.8 percent of patients taking St.-John’s-wort and 52.8 percent taking standard medications. Only 0.8 percent of patients dropped out of the study because of side effects from St. John’s wort, whereas 3 percent of those taking conventional drugs dropped out because of side effects.
The authors concluded that St. John’s wort was significantly better than a placebo and as effective as conventional antidepressant drugs in relieving mild to moderate depression with far fewer and less serious side effects. They recommended further clinical trials comparing St. John’s wort with standard antidepressant drugs to discover the most effective form of extract and work out the optimal dosage.
Steven Foster is an author, photographer and consultant, specializing in medicinal plants.
Linde, K., et al. “St.-John’s-wort for Depression: An Overview and Meta-analysis of Randomized Clinical Trials”. British Medical Journal 1996, 313:253-258.