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Studies Comparing Hypericum with Synthetic Drugs
Summary and general comments
- There are at least eight randomized, double-blind studies comparing
the antidepressant and anxiolytic effect of Hypericum perforatum
to reference medications. The reference substances were Imipramine
(2 studies), Amitryptilin (2 studies), Diazepam (2 studies) Maprotiline,
and Desipramine . There is also one study comparing hypericum
and Maprotiline regarding their effect on EEG and evoked potentials
in healthy volunteers
that will be referred in another section.
- Two of the studies against Desipramine and diazepam were conducted
with a combination preparation of hypericum and Valeria.
- Generally one has found a comparable antidepressant and anxiolytic
effect of hypericin to low-to medium dose treatment with synthetic
antidepressants, and a more benign side-effect profile. It is
interesting to note that side effects generally are more common
when hypericum is compared to reference substances than when it
is compared to a placebo.
- In many of the placebo-controlled studies the amount of "side
effects" and dropouts because of adverse drug reactions were
more frequent in the placebo than in the hypericum groups! This
clearly demonstrates the vast importance of suggestions and expectations
for treatment results with moderately to mildly depressed patients.
It also clearly demonstrates the difficulties in deciding whether
physical complaints during treatment are due to side effects or
are secondary to the depression.
- It has also been demonstrated that the role of placebo and suggestions
decreases with severity of depression.
- Hypericum proved superior to Imipramine in a moderate dose on
severe depressions (HAMD>21) in the study by Vorbach et al.
This contradicts the findings of other researchers, who only recommend
hypericum for the treatment of mild to moderate depressions. More
studies are needed to further investigate this.
- It is also interesting to note the long-range effects of hypericum.
It seems obvious that the effect continues to accumulate over
a long time so that studies conducted over a longer period of
time (6 weeks) generally show more significant effects. More studies
that follow hypericum treatment for a longer period of time are
needed in order to investigate the true therapeutic opportunities.
- All the researchers involved clearly recommend hypericum for
the treatment of mild to moderate depressions in outpatient clinics
due to its broad therapeutic window, benign effect-side-effect
profile and good compliance.
- In this book we will take a further look at four of these studies.
- The results of the studies are summarized in Table 2.
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