Posted by Larry Hoover on February 14, 2005, at 18:01:12
In reply to SJW ok for severe depression?, posted by KaraS on January 10, 2005, at 16:51:19
> I need to start on something quickly and I can't seem to make up my mind. I'd rather be on something more natural but I wonder if SJW is strong enough for fairly severe depression. I am in the process of increasing my fish oil and could augment the SJW with some other things as well. Is this an ok choice for me now?
> Those of you who were helped by SJW, was your depression beyond mild to moderate?
Yes, SJW works in severe depression. For some obtuse reason, it has only once been tested for that. Note the doses are twice the typical dose, which is quite in line with expectations of dose-responsivity. LI 160 is Jarsin/Kira.
Pharmacopsychiatry. 1997 Sep;30 Suppl 2:81-5.
Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10.
Vorbach EU, Arnoldt KH, Hubner WD.
Department of Psychiatry and Psychotherapy, Ev. Krankenhaus Elisabethenstift, Darmstadt, Germany.
The special extract of St. John's wort, LI 160, exhibited a superior antidepressant efficacy compared to placebo in several controlled trials. Two further trials demonstrated a similar reduction of depressive symptomatology under LI 160 compared to tricyclics. All these trials were performed in mildly to moderately depressed patients. The present investigation was a randomized, controlled, multicentre, 6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in severely depressed patients according to ICD-10. The main efficacy parameter, a reduction of the total score of the Hamilton Depression Scale, proved both treatment regimens very effective at the end of the 6 week treatment period (mean values 25.3 to 14.5 in the LI 160 group and 26.1 to 13.6 in the imipramine group), but not statistically equivalent within a a-priori defined 25% interval of deviation. The analysis of subgroups with more than a 33% and 50% reduction of the HAMD total score justified the assumption of equivalence within a 25% deviation interval. This view was also supported by the global efficacy ratings from patients and investigators. Regarding adverse events, the nonrejection of the nonequivalence hypothesis denotes a superiority of the herbal antidepressant. These main result indicate that LI 160 might be a treatment alternative to the synthetic tricyclic antidepressant imipramine in the majority of severe forms of depressions. However, more studies of this type must be performed before a stronger recommendation can be made.
Sorry for answering late.