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June 29, 2001
Earlier this week, a panel of medical and scientific experts announced a new review of more than 30 clinical trials on St. John's wort that reconfirmed it is safe and beneficial for mild to moderate depression, stress and anxiety. They released an advance copy of key findings on St. John's wort from a study to be released later this summer. Depression frequently accompanies chronic illnesses such as Chronic Fatigue Syndrome and Fibromyalgia and a reported 19 million Americans suffer from depression. The panel of experts hopes these findings will enable consumers to make educated health decisions.
The medical professionals urged the public to be wary of results from an impending study of St. John's wort funded by the National Institutes of Health (NIH) that focuses on major depression, and not the mild to moderate depression for which St. John's wort is recommended. The $4.3 million NIH study examined the effectiveness of St. John's wort in relieving severe symptoms of major depression, and an announcement of the results is expected this summer or early fall.
"Our expert panel review concluded that for those suffering from mild or moderate depression, St. John's wort is a much safer option with fewer side effects," said Tieraona Low Dog, M.D., an assistant professor for the Department of Family and Community Health at the University of New Mexico School of Medicine. "I often prefer it to more potent drugs, at least as the first line of treatment." In her practice, Dr. Low Dog also uses St. John's wort for menopausal irritability and in combination with calcium for premenstrual syndrome.
"The NIH study involving patients with chronic and rather severe depressive symptoms is questionable," stated Norman E. Rosenthal, M.D., a psychiatrist with Georgetown Medical Center. "It throws doubt on an herb that has been used for many years to help many people."
Jerry Cott, Ph.D., a neuropyschopharmacologist and former chief of the Psychopharmacology Research Program at the National Institute of Mental Health, explained that initial discussions of the NIH study design focused on patients with mild to moderate symptoms of depression, consistent with the documented use of St. John's wort. The rationale to shift the focus of this large multicenter trial - to patients with severe symptoms with little previous evidence of benefit - remains unclear.
The rich body of evidence supporting the benefit of St. John's wort was briefly reviewed by John Cardellina II, Ph.D., vice president of botanical science and regulatory affairs at the Council for Responsible Nutrition. Dr. Cardellina stated, "There is a strong, significant, and consistent body of evidence -- based on more than 30 controlled clinical trials -- that St. John's wort provides benefit in relieving mild to moderate symptoms of depression. These studies were also used in an evidence-based report by the Agency for Healthcare Research and Quality, which concluded 'Hypericum (St. John's wort) appears to be more effective than placebo for short-term treatment of mild to moderately severe depressive disorders.'"
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