The effectiveness of St. John's Wort in major depressive disorder: a naturalistic phase 2 follow-up in which nonresponders were provided alternate medication |
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Authors: | Gelenberg Alan J Shelton Richard C Crits-Christoph Paul Keller Martin B Dunner David L Hirschfeld Robert M A Thase Michael E Russell James M Lydiard R Bruce Gallop Robert J Todd Linda Hellerstein David J Goodnick Paul J Keitner Gabor I Stahl Stephen M Halbreich Uriel Hopkins Heather S |
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Institution: | University of Arizona Health Sciences Center, Tucson, AZ 85724, USA. alang@u.arizona.edu |
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Abstract: | BACKGROUND: A continuation study of an extract of St. John's wort (Hypericum perforatum) for depression was performed in follow-up to an acute study that found no significant difference between St. John's wort extract and placebo. METHOD: Seventeen subjects with DSM-IV-defined major depressive disorder who responded to St. John's wort extract in the acute-phase study (phase 1) were continued on double-blind treatment with the same preparation for 24 weeks. Ninety-five subjects who did not respond to either St. John's wort or placebo were treated with an antidepressant for 24 weeks. RESULTS: During antidepressant treatment, mean scores on the Hamilton Rating Scale for Depression for phase 1 nonresponders decreased significantly (p <.0001), with no significant difference between St. John's wort nonresponders and placebo nonresponders. Of the 17 subjects continued on treatment with St. John's wort extract, 5 (29.4%) relapsed. CONCLUSIONS: The subjects who did not respond to St. John's wort extract or placebo in phase 1 were, by and large, not resistant to antidepressant treatment. This suggests that the lack of efficacy found by Shelton et al. in the acute-phase study was unlikely to be the result of a high proportion of treatment-resistant subjects. |
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