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July 4, 2001

St John's Wort and Major Depression

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(1):42-45. doi:10.1001/jama.286.1.42

To the Editor: Dr Shelton and colleagues1 found that St John's wort (Hypericum perforatum) was ineffective to treat chronic major depression. St John's wort, however, is generally recommended for use in mild-to-moderate depressive disorders. From the study design, it is unclear whether any medication would have been effective in this sample since no patient received conventional antidepressant medications and an unusually low placebo response rate occurred (18.6%, as compared with the usual 30% to 50% placebo response in other trials on depression). We find no evidence in this study that precludes potential benefits for patients who were less severely and chronically depressed. In fact, according to one definition of remission, a significantly greater percentage of patients responded to St John's wort (14.3%) than to placebo (4.9%), even in this study.

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