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St John's wort was no better than placebo for reducing depression scores

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 QUESTION: In patients with major depression, is St John's wort (Hypericum extract) better than placebo for reducing depressive symptoms?


Randomised (allocation concealed*), blinded {clinicians, patients, outcome assessors, and statisticians},* placebo controlled trial with 8 weeks of follow up.


11 academic medical centres in the USA.


200 physically healthy outpatients who were ≥ 18 years of age (mean age 42.4 y, 64% women); had major depression (single episode or recurrent) without psychotic features according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for ≥ 4 weeks; and scored ≥ 20 on the Hamilton Depression Rating Scale (HDRS). Exclusion criteria included having cognitive, post-traumatic stress, eating, or substance use disorders in the previous 6 months; panic disorder in the previous year; and bipolar, psychotic, or primary personality disorders. Patients who improved during the 1 week placebo run-in period were …

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  • Sources of funding: Pfizer Inc. and National Institute of Mental Health.

  • For correspondence: Dr R C Shelton, 1500 21st Avenue South, Suite 2200, Nashville, TN 37212, USA. Fax +1 615 343 9038.

  • Abstract and commentary also appear in Evidence-Based Mental Health.

  • * See glossary.

  • Information provided by author.