What Is St. 's Wort? How Effective Is St. 's Wort?

[Guest guest]

What Is St. 's Wort? How Effective Is St. 's Wort?

http://www.medicalnewstoday.com/articles/174928.php

St. 's wort, or Perforate St. 's wart, Tipton's Weed or Klamath weed, is

a medication that comes from a flowering plant called Hypericum perforatum. For

a long time it is believed to have medicinal qualities, especially for the

treatment of depression. Recent studies appear to conclude more favorably than

unfavorably regarding St. 's Wort's efficacy in treating depression.

St. 's wort is also known as: Amber, Amber Touch-and-Heal, Demon Chaser,

Fuga Daemonum, Goatweed, Hardhay, Hypereikon, Hyperici Herba, Klamath Weed,

Millepertuis, Rosin Rose, Saynt Johannes Wort, and SJW.

Studies from reputable research centers report that St. 's wort is more

effective than a placebo and equally effective as tricyclic antidepressant drugs

in the short-term (1 to 3 months) treatment of mild-to-moderate major

depression. Experts continue to debate whether St. 's wort is as effective

as SSRIs (selective serotonin reuptake inhibitors).

Experts say that the active chemical in St. 's wort - hypercin - is probably

what gives the herb most of its efficacy. The herb also has other chemicals

which may play a role.

People taking St. 's wort must remember that there is a risk of significant

interaction with other herbs, supplements or prescription drugs. Anybody using

this medication should first check with a qualified pharmacist or their doctor.

A report in the Cochrane Review stated:

The available evidence suggests that the hypericum extracts tested in the

included trials..

... are superior to placebo in patients with major depression

... are similarly effective as standard antidepressants

... have fewer side effects than standard antidepressants. There are two issues

which complicate the interpretation of our findings:

While the influence of precision on study results in placebo-controlled trials

is less pronounced in this updated version of our review compared to the

previous version (Linde 2005a), results from more precise trials still show

smaller effects over placebo than less precise trials.

Results from German-language countries are considerably more favorable for

hypericum than trials from other countries.

Some people taking St. 's wort may experience photosensitivity (sun

sensitivity), stomach upset and allergic reactions.

Why the name " St. 's " ?

The plant is named after St. the Baptist, whose feast day (24th June)

occurs when the plant is in full bloom. Red spots are said to appear on the

plant's leaves on August 29th in the northern hemisphere - the anniversary of

the death of the Baptist (St. ), representing the blood spilt when he

was beheaded. Some say the herb was used to treat the wounded in the crusades by

the Knights of St. .

St. 's wort has been used for hundreds of years in folk medicine, especially

for the healing of wounds. It was used for " driving out the inner devil " in

medieval times. Paracelcus (c1525), a philosopher, recommended the herb for

hallucinations and dragons, as well as for healing wounds.

In 1959 and 1971 St. 's wort's antibacterial properties were scientifically

reported - its antibacterial substance, hyperforin was extracted and analyzed.

Medical use of St. 's wort

St. 's wort is widely used in Europe, especially Germany, as an herbal

treatment for depression. Its therapeutic use has been growing in other parts of

the world over the last two decades. German GPs (general practitioners, primary

care physicians) commonly prescribe the herb for some patients with depression,

especially adolescents and children.

In most countries St. 's wort is an OTC (over-the-counter, no prescription

required) medication. In others a prescription is required (for example,

Ireland).

Herbalists commonly use a fluid extract rather than a tincture. Most people take

the herb either in tablet or capsule form, but it is also available in teabags

and tinctures (a medicinal extract in a solution of alcohol).

What is the evidence for St. 's wort's effectiveness?

According to The Mayo Clinic, USA, and some other sources, St. 's wort has

been tested for the following conditions:

Depressive disorder - for the last twenty or so years St. 's wort has been

extensively studied in Europe, while US studies have occurred more recently. For

the treatment of mild-to-moderate major depression, studies lasting up to 12

weeks (short-term studies) indicate that the herb is more effective than a dummy

drug (placebo), as well as being as equally effective as TCAs (tricyclic

antidepressants).

Although studies comparing St. 's wort against SSRIs (selective serotonin

reuptake inhibitor), such as Prozac (fluoxetine) or Zoloft (sertraline) have so

far been more limited, there is some evidence that the herb may possibly be just

as effective, and also with fewer side effects.

The Mayo Clinic concludes that there is good scientific evidence for St. 's

wort's use in the treatment of depressive disorders.

ADHD (attention deficit hyperactivity disorder) in children - research is either

unclear or unfavorable. Scientists from Bastyr University, Kenmore, Washington,

found that St. 's wort was no more effective than a placebo in treating

ADHD.

Anxiety disorder - the Mayo Clinic says that there is no compelling evidence

either way for the treatment of anxiety disorder. In other words, there is not

enough evidence to say it is effective, and neither is there evidence to say it

does not work. Further studies are needed. However, there are many doctors in

Europe who say St. 's wort helps patients with anxiety disorders.

Atopic dermatitis - a study which looked at the effectiveness of hypericum cream

suggested that mild to moderate atopic dermatitis may respond positively to

topical treatment.

Burning mouth syndrome (type of pain) - the Mayo Clinic informs that it is

unclear whether St. 's wort is effective. Further studies are required.

Depression in children - currently most scientists and experts say that there is

not enough compelling evidence to determine whether the herb is effective for

the treatment of depression in children. Doctors in Europe may view the herb

more favorably than those in the USA.

Nerve pain - some preliminary studies have demonstrated that St. 's wort may

help treat neuropathic pain. Further research is needed in this area.

OCD (obsessive-compulsive disorder) - some reports indicate that the herb might

offer some benefits for patients with OCD. However, further studies are

required.

Somatoform disorders - these are disorders that have physical symptoms which

cannot be linked to an organic disease, and appear to be of psychic origin.

Preliminary evidence suggests that St. 's wort may be useful in the

treatment of some somatoform disorders. Results need to be confirmed with more

extensive tests.

Post-operative pain - more studies are needed in this area. So far, evidence is

unclear.

HIV (human immunodeficiency virus) - although animal studies reported some

anti-viral effects of St. 's wort, one human trial did not. Because of

multiple reports of considerable adverse events and interactions with HIV/AIDS

medications, including PIs (protease inhibitors) and NNRTIs (non-nucleoside

reverse transcriptase inhibitors), doctors advise HIV/AIDS patients to avoid

taking St. 's wort.

The Mayo Clinic adds that further research is required for the treatments for

peri-menopausal symptoms, PMS (premenstrual syndrome), SAD (seasonal affective

disorder), social phobia and severe depressive disorder.

Dosages used in St 's wort trials

Adults - human trials have used dosages ranging from 0.17 to 2.7 milligrams of

hypercin (oral), and 900 to 1,800 milligrams of St. 's wort extract (oral)

daily. For the treatment of atopic dermatitis, 1.5% hyperforin (verum) has been

applied to the skin.

Children - human trials with children have used from 150 to 1,800 milligrams of

St. 's wort extract daily (oral), with good tolerability.

What are the possible side effects of St. 's wort?

The majority of studies have been short-term ones (up to 12 weeks). During those

periods St. 's work has generally been well tolerated at the above-mentioned

doses.

If side effects do occur, they may include:

Anxiety

Dizziness

Dry mouth

Headache

Light sensitivity

Restlessness

Sedation

Sexual dysfunction

Skin reactions

Stomach upset

Tiredness (fatigue)

Studies suggest that up to 3% of patients may experience side effects. Side

effects are generally much less than those experienced with standard medications

used for the treatment of depression.

Patients should NOT take St. 's wort if they are taking the following

medications because their effectiveness may be reduced:

Anticonvulsants

Cyclosporine

Digoxin

Oral contraceptives

Some anti-HIV drugs

Theophylline

Warfarin

St. 's wort should not be taken if you are taking the following medications,

because it can have an additional effect on these drugs, which may cause

problems:

SSRI antidepressants (selective serotonin reuptake inhibitors)

Triptan drugs used for migraine, such as sumatriptan

Pregnancy or breastfeeding mothers - currently, we do not know whether or not it

is safe to take St. 's wort if a mother is pregnant or breastfeeding.

The National Health Service (NHS), UK, advises patients to see their doctor

first before taking St. 's wort, especially if they are already taking

medications.

Lay people (in this text " non-scientists " ) tend to think that natural products,

such as herbs are all safe, just because they are natural. This is not true.

Some natural mushrooms may be good for you, while others are extremely dangerous

if consumed. Examples of poisonous natural plants include aconite, balsam apple,

baneberry, deadly nightshade, yew, bloodroot, foxglove, hemlock, poison ivy,

white poppy. In fact, some deadly plants and herbs have been artificially

manipulated and turned into life-saving medications - in other words, some

plants may kill you in their natural form and save lives when artificially

processed. A plant of the genus Digitalis (including foxgloves) is a source of

cardioactive steroid glycosides commonly used in the treatment of some heart

diseases.