Study Raises Questions about Efficacy of St. John’s Wort
The herbal supplement St. John's wort may be ineffective in treating people with "moderate[ly] sever[e]" depression, a new study in today's Journal of the American Medical Association indicates (Vedantam, Washington Post, 4/10). In the first study to be funded by NIH's National Center for Complementary and Alternative Medicine, researchers from Duke University Medical Center randomly assigned 340 people to receive hypericum, the active ingredient in St. John's wort; Zoloft, the world's best-selling anti-depressant; or a placebo (Burton, Wall Street Journal, 4/10). Study subjects were "depressed enough to withdraw from some of their work and hobbies, but not so severely ill as to contemplate suicide," the Post reports (Washington Post, 4/10). Of those patients taking St. John's wort, 23.9% experienced a "complete lifting of depression," compared with 24.8% of subjects taking Zoloft and 31.9% of those taking the placebo (Wall Street Journal, 4/10). "I wouldn't write (St. John's wort) off, but I don't think it's a leading candidate for the treatment of moderately severe depression," Jonathan Davidson, the study's lead researcher and director of the Anxiety and Traumatic Stress Program at Duke University Medical Center, said (Hellmich, USA Today, 4/10).
Mark Blumenthal of the American Botanical Council said that "numerous" studies have shown both St. John's wort and Zoloft are effective in treating depression, and "the fact that neither worked in this study only shows that the patients in this group didn't respond to either treatment." John Cardellina of the Council for Responsible Nutrition, a trade association for the dietary supplement industry, added that more than 30 clinical trials -- mostly completed in Europe -- have indicated St. John's wort is "useful" for people with "mild to moderate forms of depression." Cardellina added, "We don't understand why the government would target the study against moderately severe depression when that's not what St. John's wort is recommended for" (USA Today, 4/10). Researchers also "play[ed] down" the significance of the results for those patients who took Zoloft. According to the Wall Street Journal, study volunteers received doses between 50 and 100 milligrams, although patients often receive a 200-milligram dose. Researchers added that the study "may have been too small" for the Zoloft results to be "statistically significant." Still, Zoloft supporters noted that study volunteers who took Zoloft received the highest scores in "overall mood," based on the Hamilton Depression Scale (Wall Street Journal, 4/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.