A number of clinical studies conducted over the past few years have in
dicated that whole extract of St John's wort (Hypericum perforatum L.)
has antidepressant effects. The herbal antidepressant St John's wort
offers promising results in the treatment of patients with mild and mo
derate depression (response rate of 60-70% estimated by analysis of po
oled data). St John's wort preparations are well tolerated. Their use
rarely leads to adverse drug reactions which, when they do occur, are
mainly subjective symptoms (e.g. gastrointestinal, dizziness). The gen
erally good tolerability of St John's wort preparations and the result
ing high patient compliance in taking the prescribed medication, in co
njunction with their efficacy in mild and moderate depression, make th
ese preparations particularly suitable for use in outpatient practice.
Tolerability is also very good in elderly patients. If a sufficiently
high-dose course of treatment with St John's wort preparations (900 m
g daily) does not lead to a clear improvement in depression after four
to six weeks, therapy should be continued with an established ('class
ical') antidepressant.