Hypericum perforatum, more commonly known as St. John's wort, is an herbal product that has been utilized as an antidepressant in Europe for many years. This product has become popular in the United States as an alternative to traditional antidepressants. Due to the fact that St. John's wort is not regulated by the Food and Drug Administration (FDA), many questions exist about the safety and efficacy of this product. This article will provide a review of the history, pharmacology, and safety profile of St. John' wort, as well as its efficacy in the treatment of major depressive disorder.
Meruelo D,Lavie G,Lavie D..Therapeutic agents with dramatic antiretroviral activity and little toxicity at effective doses: aromatic polycyclic diones hypericin and pseudohypericin..Proc Natl Acad Sci USA. 1988;85:5230-5234
4.
Linde K,Ramirez G,Mulrow Cd,Pauls A,Weidenhammer W,Melchart D..St. John's Wort for depression—an overview and meta-analysis of randomized clinical trials.BMJ. 1996;313:253-258
Bloomfield Hh,Nordfors M,McWilliams P.Hypericum and Depression. Los Angeles, CA: Prelude Press; 1996:
7.
Nahrstedt A,Butterweck V..Biologically active and other chemical constituents of the herb of Hypericum perforatum L.Pharmacopsychiatry. 1997;30 (Suppl): 129-134
8.
Bennett Da,Puhn L,Polk Jf,Voglino Sa,Zlothik V,Raffa Rb..Neuropharmacology of St. John's Wort.Ann Pharmacother. 1998;32:1201-1208
9.
Biber A,Fischer H,Romer A,Chatterjee Ss..Oral bioavailability of hyperforin from hypericum extracts in rats and human volunteers.Pharmacopsychiatry. 1998;38 (suppl): 36-43
10.
Suzuki O,Katsumata Y,Oya M,Bladt S,Wagner H..Inhibition of monoamine oxidase by hypericin.Planta Med. 1984;50:272-274
11.
Bladt S,Wagner H..Inhibition of MAO by fractions and constituents of Hypericum extracts.J Geriatr Psychiatry Neurol. 1994;7 (suppl 1): S57-S59
12.
Holtje Hd,Walper A..Molecular modeling of the antidepressive mechanism of Hypericum ingredients.Nervenheilkunde. 1993;12:339-340
13.
Staffeldt B,Kerb R,Brockmoeller J,Ploch M,Roots I..Pharmacokinetics of hypericin and pseudohypericin after local intake of the Hypericum perforatum extract LI 160 in healthy volunteers.J Geriatr Psychiatry Neurology. 1994;7 (suppl 1): S47-S53
14.
Thiede Hm,Walper A..Inhibition of MAO and COMT by Hypericum extracts and hypericin.J Geriatr Psychiatry Neurol. 7 (suppl 1): S57-S59
15.
Perovic S,Muller Neg..Pharmacological profile of Hypericum extract: effect on serotonin uptake by post-synaptic receptors.Arzneimi Helforschung. 1995;45:1145-1148
16.
Muller We,Schafer Cs.1996. St. John's Wort: In vitro study about Hypericum extract, hypericin and kampferal as antidepressants.Deutsche Apotheker Zeitung. 1996;136 (13): 1015-1022
17.
Muller We,Rolli M,Schafer C,Hafner U..Effects on Hypericum extract (LI160) in biochemical models of antidepressant activity,.Pharmacopsychiatry. 1998;30 (suppl 2): 102-107
18.
Wonnemann M,Schafer C,Muller E..Effects of hypericum perforatum extracts on glutamatergic and GABAergic receptor systems.Pharmacopsychiatry.. 1997;30:237
19.
Chatterjee Ss,Bhattacharya Sk,Wonnemann M,Singer A,Muller We..Hyperforin as a possible antidepressant component of hypericum extracts.Life Sciences. 1998;63:499-510
20.
Brockmoller J,Reum T,Bauer S,Kerb R,Hubner W-D,Roots I..Hypericin and pseudohypericin: pharmacokinetics and effects on photosensitivity in humans.Pharmacopsychiatry. 1997;30 (suppl): 94-101
21.
Vorbach Eu,Arnoldt Kh,Hubner Wd..Efficacy and tolerability of St. John's Wort extract LI 160 versus imipramine in patients with severe depressive episodes acording to ICD–10.Pharmacopsychiatry. 1997;30 (suppl): 81-85
22.
Ernst E,Rand Ji,Barnes J,Stevinson C..Adverse effects profile of the herbal antidepressant St. John's Wort.Eur J Clin Pharmacol. 1998;54:589-594
23.
23.FDA Talk Paper.FDA warns against drug promotion on “Herbal Fen-Phen.” Sent by cnorwood@bangate.fda.gov on November 6, 1997.
Hansgen Kd,Vesper J,Ploch M..Multi-center double-blind study examining the antidepressant effectiveness of Hypericum extract LI 160.J Geriatr Psychiatry Neurol. 1994;7 (suppl 1): S15-S18
26.
Volz Hp..Controlled clinical trials of Hypericum extracts in depressed patients: an overview.Pharmacopsychiatry. 1997;30 (suppl 2): 72-76
27.
LI160, an extract of St. John's wort, versus amitriptyline in mildly to moderately depressed outpatients—a controlled 6 week clinical trial.Pharmacopsychiatry. 1993;30 (suppl 2): 77-80
28.
Josey Es,Tackett Rl..St. John's wor: a new alternative for depression?.International Journal of Clinical Pharm Ther. 1999;37:111-119
29.
Upton R.St. John's Wort Monograph. American Herbal Pharmacopeia and therapeutic compendium.. Santa Cruz, CA: American Herbal Pharmacopeia; 1997:
30.
30.St. John's WortNIH depression study to begin in spring. F-D-C Reports. The Tan Sheet. October 6, 1997.
