Hypericum for depression - An update of the clinical evidence

This review is aimed at providing an updated evaluation of the clinical evi dence regarding Hypericum perforatum (St. John's wort) as an antidepressant , based on recently published radomised controlled trials. Computerised lit erature searches revealed six trials published since the metaanalysis by Li nde et al. (1996) [Linde, K., Ramirez, G., Mull ow, C.D., Pauls, A., Weiden hammer, W., Melchart, D., 1996. St. John's wort for depression - an overvie w and meta-analysis of randomised clinical trials. Br. Med. J. 313, 253-258 ]. The results of these studies provide further evidence that hypericum is superior to placebo in treating mild or moderate depression. However, there is still insufficient evidence to assess the efficacy of hypericum in comp arison with conventional, particularly modern, antidepressants. Furthermore , there remains a lack of trials assessing long-term effects, other types o f depression and different preparations and doses. It is concluded that rec ent clinical trials strengthen the case for hypericum as an antidepressant, but more work needs to be done to answer the remaining questions. (C) 1999 Elsevier Science B.V. All rights reserved.