Table 4 Trials testing St. John's wort
From: Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review
Reference | Study Design | Sample Population | Intervention | Control | Length of Treatment | Outcomes | Direction of Evidence | Reported Adverse Events |
|---|---|---|---|---|---|---|---|---|
Taylor (2000) [63] | Open-label; Uncontrolled; Observational | 13 subjects with a primary DSM-IV diagnosis of OCD of at least 12 month duration | Fixed dose of 900 mg/day of 0.3% hypericin (a psychoactive compound in Hypericum) | N/A | 12 weeks | Significant improvement in Y-BOCS scores in SJW group (comparable to those seen in clinical trials with SSRIs). | + | Diarrhea Restless sleep |
Volz (2002) [61] | Randomized; Double-blind; Parallel Group | 149 outpatients diagnosed with somatization Disorder2, undifferentiated somatoformDisorder3, or somatoform autonomic Dysfunctions4 | Hypericum extract LI 160 (600 mg/day) | Placebo | 6 weeks | Significant reduction in anxiety (HAMA-SOM, CGI, HAMA-T, HAMA-PSY, HDS, SCL-90-R, SCL-90-R-ANX) in favour of SJW treatment. | + | Verywell tolerated. Mild/moderate: Abdominal pain Arthritis Arrythmia Bronchitis Cystitis Headache Neuralgia |
Muller (2003) [62] | Open-label; uncontrolled observational | 500 patients diagnosed with depression comorbid with anxiety | (1) 500 mg valerian extract5 and 600 mg/day St John's Wort6(2) 1,000 mg valerian extract7 and 600 mg/day St John's wort6 | N/A | 6 weeks | Significant reduction in anxiety disorder symptoms (HAMA) in both treatment groups. Higher dosage results in greater improvements. | + | Allergy Bad dreams Sleep disorders Dysphoria |
Kobak (2005) [60] | Randomized; Double-blind;Parallel Group | 40 subjects with GAD | St John's wort8; flexible dose (600-1800 mg/day), mean dose at week 12 was 1676 mg/day | Placebo | 12 weeks | No significant difference to placebo (LSAS) | - | Similar to placebo. Mild/moderate: Gastrointestinal upset Dizziness Insomnia Fatigue |
Kobak (2005) [59] | Randomized; Double-blind; Parallel Group | 60 outpatients with primary diagnosis of OCD | St John's wort LI 1608; flexible dose (600-1800 mg/day), mean dose at week 12 was 1663 mg/day | Placebo | 12 weeks | No significant difference to placebo (Y-BOCS) | - | Similar to placebo9. Mild/moderate: Headache Gastrointestinal symptoms Fatigue Agitation Sleep disturbance |
Sarris (2009) [51] | Randomized; Double-blind; Crossover | 28 adults with MDD and co-occurring anxiety | Hypericum perforatum10 (1 × 1.8 g tablet, three times/day); Kava rhizome aqueous extract11(1 × 2.66 g tablet, 3 times/day) | Placebo | 4 weeks | Combination treatment had no significant effects on anxiety (BDI-II). | - | No serious adverse events. Mild gastrointestinal upset. No liver toxicity |