- A specially prepared extract of the herb St John's wort
is at least as effective in treating depression as the powerful antidepressant
drug Seroxat [Paxil] and has fewer side-effects, a study has indicated.
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- St John's wort has long been known as an effective herbal
treatment for mild depression but the latest study is the first to suggest
that it may have equal effectiveness with one of the biggest-selling pharmaceutical
treatments for moderate to severe depression.
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- Researchers who asked 301 people with depression to take
part in the trial found that half of those given St John's wort for six
weeks reported an improvement in their symptoms, compared with only one
third given Seroxat.
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- Neither group knew which drug they were taking, but those
given Seroxat also reported more side-effects.
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- Seroxat has been at the centre of allegations that in
some patients it causes agitation at the start of treatment and withdrawal
effects in those trying to come off it. An investigation by the Medicines
and Healthcare Regulatory Authority concluded last year that it should
be avoided in mild depression, because of the side-effects. The authority
ordered a ban on its use in patients under 18.
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- The study is published in the online version of the British
Medical Journal. The researchers from Germany say: "Our results support
the use of [St John's wort extract] as an alternative to standard antidepressants
in moderate to severe depression, especially as it is well tolerated."
They add that the drug should be assessed for long-term treatment, because
many patients suffer chronic depression and the "favourable ratio
between efficacy and tolerability" of St John's wort makes it an "interesting
option" in these patients.
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- In 2004, about 19 million prescriptions for antidepressants
were issued to about 3.5 million patients at a total cost of £400m
in the UK.
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- In recommendations issued in December, the National Institute
for Clinical Excellence (Nice) said that given the well-known side-effects
of such drugs, including anxiety, insomnia, headaches and stomach complaints,
alternative treatments should be considered for people with mild depression.
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- Nice recommended that counselling including cognitive
behavioural therapy should be considered. But the Royal College of GPs
said the shortage of counsellors and psychotherapists meant this was impractical.
"GPs often feel they have little choice but to prescribe antidepressants,"
a spokesman said.
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- In Germany, where St John's wort is a prescription drug,
it outsells Prozac by four to one.
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- One drawback is that St John's wort interacts with several
prescription medicines to reduce their effectiveness.
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- ©2005 Independent News & Media (UK) Ltd.
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- http://news.independent.co.uk/
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