St. John's Wort (Hypericum perforatum) was the fast selling herb in the world last year! In fact, the demand far exceeded the supply. It is the darling of the American media that has dubbed it as "the herb of the new millenium". Not bad for a herb that came into public view just in 1997. It did not stop there. There was a high profile two page feature article in Newsweek, countless mentions in magazines and newspapers, programs on TV and radio, and even a segment on the widely watched TV show 20/20.All this made this herb a household name in the United States. Americans were going to their psychiatrists and literally asking, "Why did you not tell me this herb for my depression before?".

What propelled St. John's Wort to the status of superstar herbal antidepressant was a study that was published in the British Medical Journal in 1996. The study was entitled, "St. John's Wort for depression--an overview and meta-analysis of randomised clinical trials". It generated such media attention because is a meta-analysis. In other words, it was not just one study. Meta-Analysis The authors thoroughly reviewed a list of 23 previous studies published involving this herb and tabulated the results. Most of these studies were published in foreign journals and in foreign languages, mostly German. Thus, it had not attracted the attention of the mainstream American media. St. John's Wort was however well-known in the alternative health field. Countless articles had been published about it in a variety of alternative health magazines.

The objective of the researchers was to investigate if extracts of Hypericum perforatum (St. John's Wort) are more effective than placebo in the treatment of depression, are as effective as standard antidepressive treatment, and have fewer side effects than standard antidepressant drugs. Side Effects Scanning patients from 23 different studies yielded 1757 patients with mainly mild or moderate depression. Fifteen of these studies were placebo-controlled, meaning that some patients were given the herb and other patients were given a dummy pill. Neither group would know until the end of the study if they were given real medicine. Doing a placebo-controlled study is essential in order to avoid the expectations and hopes patients feel when they are placed on a medicine.

In addition to these fifteen studies, eight others compared the effectiveness of this herb compared to another antidepressant drug. For instance, one such study compared maprotiline, an older standard antidepressant, to St. John's Wort (Harrer, 1994). The effectiveness of the herb was found to be similar to the drug - not bad for a herb. However, patients on maprotiline complained of unpleasant side effects such as lethargy and dryness of mouth. The meta-analysis showed that St. John's Wort was significantly superior to placebo and was as effective as a pharmaceutical antidepressant-- and with much fewer side effects. In fact, more than half of the patients on prescription antidepressant drugs reported side effects while less than 20 % of those on the herb did so. The researchers concluded that, "There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders."

Copyright © Rajen M.