Hypericum extract is therapeutically equivalent to, but better tolerated than, imipramine for treating mild to moderate depression, a study has found.
In a randomised, double blind trial of 324 patients, Dr Helmut Woelk (medical director, Akademisches Lehrkrankenhaus der Universitat Giessen, Germany) and colleagues compared the efficacy and tolerability of Hypericum perforatum extract ZE 117 250mg twice daily with imipramine 75mg twice daily, for six weeks. The Hamilton depression rating scale was used to assess response.
The researchers found that adverse events were reported by more participants treated with imipramine than with hypericum. Three per cent of patients stopped hypericum treatment due to adverse events compared with 16 per cent of participants taking imipramine, they say. The most commonly reported adverse event in both groups was dry mouth. However, 25 per cent of participants in the imipramine group experienced dry mouth compared with 8 per cent in the hypericum group.
The researchers comment: "In view of the mounting evidence of hypericum's comparable efficacy to other antidepressants and its safety record, hypericum should be considered for first line treatment in mild to moderate depression, especially in the primary care setting" (British Medical Journal 2000;321:536).