PMID- 16428030
OWN - NLM
STAT- MEDLINE
DCOM- 20060419
LR  - 20061115
IS  - 0944-7113 (Print)
IS  - 0944-7113 (Linking)
VI  - 13
IP  - 3
DP  - 2006 Feb
TI  - Safety of St. John's Wort extract compared to synthetic antidepressants.
PG  - 199-204
AB  - The clinical efficacy of some standardized St. John's Wort extracts (SWEs) such 
      as WS((R)) 5570, WS((R)) 5572 or LI 160 in the treatment of mild, moderate and 
      severe major depression has been demonstrated in 38 controlled clinical trials 
      and two recent meta-analyses. Sixteen post-marketing surveillance studies with 
      such preparations, based on a total of 34,804 patients, recorded an incidence of 
      adverse events (AEs) among patients between 0% and 6%. Of these studies, the four 
      large-scale surveillance studies with a total of 14,245 patients recorded a rate 
      of AEs ranging from 0.1% to 2.4% and a drop-out rate due to AEs of 0.1-0.9%. This 
      is at least ten-fold lower than that recorded with synthetic antidepressants. AEs 
      associated with SWE treatment were mild and transient in nearly all cases. As 
      with synthetic antidepressants, pharmacokinetic interactions may occur 
      occasionally as a result of activity changes of drug-metabolising and 
      drug-transporting proteins, especially CYP 3A4 and P-gp. Risks to the patient are 
      not caused by SWE but by drugs with a narrow therapeutic range. Consequently, SWE 
      preparations should not be taken concurrently with other antidepressants, with 
      coumarin-type anticoagulants, the immunosuppressants cyclosporine and tacrolimus, 
      protease and reverse transcriptase inhibitors used in anti-HIV treatment or with 
      certain antineoplastic agents. However, such cases are extremely rare and, with 
      medical supervision, easily avoided. In conclusion, the safety of SWE must be 
      considered more favourable than that of synthetic antidepressants.
FAU - Schulz, V
AU  - Schulz V
AD  - v.schulz.berlin@t-online.de
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
DEP - 20051102
PL  - Germany
TA  - Phytomedicine
JT  - Phytomedicine : international journal of phytotherapy and phytopharmacology
JID - 9438794
RN  - 0 (Antidepressive Agents)
RN  - 0 (Plant Extracts)
SB  - IM
MH  - Antidepressive Agents/adverse effects/chemical synthesis/therapeutic use
MH  - Depression/*drug therapy
MH  - Dermatitis, Phototoxic/etiology
MH  - Food-Drug Interactions
MH  - Herb-Drug Interactions
MH  - Humans
MH  - Hypericum/*adverse effects
MH  - Phytotherapy/*adverse effects
MH  - Plant Extracts/*adverse effects/therapeutic use
MH  - Risk Assessment
RF  - 37
EDAT- 2006/01/24 09:00
MHDA- 2006/04/20 09:00
CRDT- 2006/01/24 09:00
PHST- 2005/06/23 00:00 [received]
PHST- 2005/07/25 00:00 [accepted]
PHST- 2006/01/24 09:00 [pubmed]
PHST- 2006/04/20 09:00 [medline]
PHST- 2006/01/24 09:00 [entrez]
AID - S0944-7113(05)00218-7 [pii]
AID - 10.1016/j.phymed.2005.07.005 [doi]
PST - ppublish
SO  - Phytomedicine. 2006 Feb;13(3):199-204. doi: 10.1016/j.phymed.2005.07.005. Epub 
      2005 Nov 2.