Hypericum-perforatum-Extrakt bei der Behandlung leichter bis mittelschwerer Depressionen Klinische und pharmakologische Aspekte

Abstract

For many years, hypericum extracts have been used in the treatment of depressive disorders. The therapeutical use of these extracts has been predominantly justified for a long time by the clinical evidence of efficacy and only partly by results of scientific studies. The aim of the present investigation is to perform a meta-analysis of the placebo- and verum-controlled studies carried out till now, to examine the relevance of hyperforin and hypericin for the clinical efficacy of St. John's Wort, to discuss biochemical and pharmacoendocrinological studies investigating the mechanism of action, and to describe side effects and interactions of hypericum extracts. In particular during recent years, methodologically quite sophisticated studies have been performed. The comprehensive evaluation of all studies available suggests a significant superiority of hypericum extracts over placebo, despite the negative results of two recently published American trials, and a therapeutic efficacy comparable to that of synthetic antidepressants in mildly to moderately depressed patients. Furthermore, it has been suggested in preclinical and clinical studies that the content of hyperforin but not of hypericin decisively contributes to the antidepressant efficacy of hypericum extracts. Hyperforin has been demonstrated in biochemical investigations--like synthetic antidepressants--to inhibit the reuptake of the neurotransmitters norepinephrine, serotonin, and dopamine. Hypericum extracts can be regarded as well tolerated, and they extend the variety of pharmacotherapeutical options in the treatment of depression, especially in outpatients. However, interactions in combination treatments are possible by interference with the cytochrom P450 system, thereby changing plasma levels of other medications.

Predicting Stable Treatment Response in Patients with Major Depression Treated with Hypericum Extract WS® 5570/5572

“…Hypericum extract preparations are among the leading antidepressants in Europe [9,23]. Their therapeutic efficacy in mild to moderate major depression has been demonstrated in numerous controlled trials against placebo and various synthetic standard antidepressants [2,6,11,12,14,20,39,40]. In this investigation, we analyze data from 3 placebo-controlled trials with Hypericum extracts WS 5570, WS 5572 and WS 5573.…”

Anwendungsbeobachtung zur Behandlung leichter bis mittelschwerer Depressionen bei weiblichen Patienten durch Lichttherapie bzw. Johanniskrautextrakt

“…Innerhalb der Gruppe der leichten bis mittelschweren Depressionen stehen Behandlungsverfahren wie Lichttherapie und Johanniskrautmedikation im Mittelpunkt wissenschaftlicher und ö ffentlicher Diskussionen [14].…”