Hypericum clearly has a place in the overall scheme of antidepressent
therapy. From clinical experience it appears to be most effective in the
treatment of mild to moderate deressions, in perhap 60% to 70% of
patients. Additionally, it seems useful as an adjunctive measure in
approximately the same percentage of more seriously depressed patients.
(Interestingly, the percentage of effectiveness seems approximately the
same as the "first line" antidepressents.) When it is effective, it works
relatively quickly - thus providing clinical relief during the initiation
phase of anti-depressent therapy with the commercial pharmaceutical
agents, all of which have a lag time before effectiveness.
The subject study is flawed by noncomparability of doses. Many of the
available comparison studies declare imipramine to be as effective as the
new agents. Practical experience does not support this finding, however.
Generally, the doses employed were not comparable.
Common sense argues that hypericum is neither a panacea nor a
placebo. It is simply another tool in our armamentarium, about which we
must learn through clinical experience.
Rapid Response:
St.John's Wort and common sense
Hypericum clearly has a place in the overall scheme of antidepressent
therapy. From clinical experience it appears to be most effective in the
treatment of mild to moderate deressions, in perhap 60% to 70% of
patients. Additionally, it seems useful as an adjunctive measure in
approximately the same percentage of more seriously depressed patients.
(Interestingly, the percentage of effectiveness seems approximately the
same as the "first line" antidepressents.) When it is effective, it works
relatively quickly - thus providing clinical relief during the initiation
phase of anti-depressent therapy with the commercial pharmaceutical
agents, all of which have a lag time before effectiveness.
The subject study is flawed by noncomparability of doses. Many of the
available comparison studies declare imipramine to be as effective as the
new agents. Practical experience does not support this finding, however.
Generally, the doses employed were not comparable.
Common sense argues that hypericum is neither a panacea nor a
placebo. It is simply another tool in our armamentarium, about which we
must learn through clinical experience.
Competing interests: No competing interests