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Herb May Help Ease Depression, Studies Show


St. John's wort, a plant used in European folk medicines to relieve depression, might actually ease some of the symptoms in some people, researchers report today.

A review of 23 different studies, most of them published in non-English medical journals, suggested that St. John's wort, known scientifically as Hypericum perforatum, worked 2.7 times better than a placebo and roughly as well as numerous antidepressant drugs in mildly depressed people. Relief of symptoms generally took days or weeks to occur.

The survey of studies, led by Dr. Klaus Linde of the Ludwig Maximilians University in Munich, involved 1,757 patients with mild to moderate depression who were cared for by family physicians.

Herbal remedy handbooks have long touted the treatment, but the new study is among the most rigorous analyses of a so-called alternative medical therapy to find a positive effect and to be published in a major, peer-reviewed medical journal. It appears in today's British Medical Journal.

"I think [St. John's wort] has the potential to be effective for lots of people and the potential to have minimal side effects," said Dr. Cynthia Mulrow, an internist at the Audie L. Murphy Memorial Veterans Hospital in San Antonio and a co-author of the study.

But she cautioned that people should not blithely treat themselves with extracts or infusions of St. John's wort. The studies that were analyzed did not clearly define what kind of depression the patients had to begin with. And she said nothing was known about the possible long-term adverse effects of heavy intake of the herb preparation.

An editorial in the British Medical Journal suggested that although the new research was promising, it failed to show that St. John's wort was effective against serious depression; that virtually nothing was known about the herb's active ingredients, and that the treatment was given for no longer than two months, providing no data on long-term side effects or the potential for patients to become tolerant of the herb's effect and relapse.

In Germany, St. John's Wort extract is sold over the counter and is prescribed as a treatment for anxiety, depression and sleep disorders. Physicians in Germany write prescriptions for St. John's wort tablets or capsules worth tens of millions of dollars each year.

In the United States, herb preparations are generally regarded by the Food and Drug Administration as foods unless they make specific medical claims, in which case they must be proven safe and effective. The agency has said that St. John's wort extracts are unsafe because in large doses they can make the skin and eyes extra sensitive to light. It is most commonly packaged here as a tea.

Linde said in an interview that all 23 of the studies that the new analysis drew upon were funded by companies that sell St. John's wort. Such corporate sponsorship undercut the data's validity somewhat, he said. "The results are quite firm," he said, "but they are maybe a little too nice."

He added that anyone who may have symptoms of depression should first see a physician before trying any remedy.

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