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QUESTION: In patients with major depression, is St John's wort (Hypericum extract) better than placebo for reducing depressive symptoms?
Design
Randomised (allocation concealed*), blinded {clinicians, patients, outcome assessors, and statisticians}†,* placebo controlled trial with 8 weeks of follow up.
Setting
11 academic medical centres in the USA.
Patients
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 …