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30.11.2023

St. John's wort outperforms SSRIs in treating depression

In case of not too serious depression, supplementation with St. John's wort does not work as well as the SSRIs that most regular psychiatrists are so fond of. According to a recent Chinese meta-study, St. John's wort works better.

Study
In February 2023, Chinese doctors published a meta-study in Advances in Clinical and Experimental Medicine in which they combined and analyzed the results of 14 previously published trials. In these trials, researchers treated people with mild to moderate depression with extracts of St. John's wort.

In a number of trials, the researchers compared the effect of St. John's wort with that of a placebo. In other trials, the researchers compared St. John's wort with selective serotonin reuptake inhibitors [SSRIs] such as fluoxetine, paroxetine and sertraline.

In the table below - click on it for a larger version - you will find more details about the dosage used and the duration of supplementation. In the typical trial, the subjects received 900 milligrams of extract per day for two months.

Results
Supplementation with St. John's wort resulted in a significant decrease in depression scores in trials that compared St. John's wort with a placebo. The figure below shows this.

Click on the figures below for a larger version.

In the figure above you can see that St. John's wort also works better than SSRIs.

The magnitude of the difference in effect in both figures is approximately the same. Based on the trials used, you may wonder whether SSRIs had any effect on depression that was not already severe.

Conclusion
"SSRIs are widely used for the treatment of depression and can significantly alleviate clinical symptoms and lower the Hamilton Depression Rating Scale score", the researchers summarize.

"However, due to their strong side effects, they are not recommended. Instead, the use of St. John's wort is preferred as it is a cheap, readily available and effective treatment strategy for mild to moderate depression, with mild side effects. Thus, based on the current meta-analysis and statistically significant results (p smaller than 0.05), the use of St. John's wort for depression in adults is strongly recommended."

Source:
Adv Clin Exp Med. 2023 Feb;32(2):151-61.

More:
St. John's wort reduces depression | Meta-study 07.07.2022
Overweight and depressed? St. John's wort kills two birds with one stone 16.07.2016

Archives:
St. John's Wort
Depression

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