In clinical practice, hypericum extract [St Johns' Wort JFH] is better tolerated than synthetic antidepressants. It may be particularly helpful in severe depression with its high risk of chronicity. We compared the efficacy and safety of hypericum extract with paroxetine in patients with moderate to severe depression.
Hypericum extract WS 5570 at a dose of 300 mg three times a day has been shown to be more effective than placebo in patients with mild to moderate major depression treated for six weeks. Paroxetine, on the other hand, is a potent selective serotonin reuptake inhibitor with proved efficacy in patients with depression of any severity and has a more favourable safety profile than tricyclic antidepressants. In major depression, daily doses between 20 mg and 50 mg have been recommended and are commonly used in clinical trials and in daily practice.
Great stuff! Here's a little bit of independence from the big pharmacos!
But Tim Watkins, Director, Depression Alliance Cymru [Wales] posted this reponse which set me thinking:
Re: Seroxat 'v' St. John's Wort: an unfair contest?
Several Studies have shown that St. John's Wort is at least as effective as TCAs and SSRIs in the treatment of depression. This research adds to our knowledge only in suggesting that St. John's Wort may be as effective in the treatment of severe depression. However, one detects a hidden agenda in this paper.
The paper is as much about suggesting that St. John's Wort is more user friendly than other antidepressants. This being so, we should question why the researchers chose to test St. John's Wort against Paroxetine (Seroxat). Of all the SSRIs, Seroxat has the worst reputation, with survivors groups around the world, accusations of a link with suicide, law suits, and enough adverse event reports to cause regulators around the world to alter their safety advice. Whether or not these allegations are true, the researchers behind this paper must have known that the Seroxat users in the trial would report a high number of adverse events, and that, consequently, St. John's Wort would appear considerably better tolerated by comparison.
The fact remains that St. John's Wort can have unpleasant side effects, and can be fatal if combined with some blood pressure drugs. What we do not have from this paper, or, as yet, from any other research is data for safety and efficacy from full-scale medical trials of the kind we would insist upon for any prescription medicine.
It is perhaps not surprising to find that the research was funded by by Dr William Schwabe Pharmaceuticals, a major supplier of so-called "herbal remedies" which can be legally sold as food addatives with no requirement to provide patient safety information or warnings about interactions with other medicines.
And yet again I'm thinking how naive am I That natural source is still processe. And of course by a "a major supplier". (And I found one bad Google reference for Dr William Schwabe Pharmaceuticals for which I couldnt find a resolution.)
Capitalism really is all pervasive