St. John's wort for depression: a meta-analysis of well-defined clinical trials

source extracted confidence: high 2026-04-09
#adult #antidepressive-agents-tricyclic #controlled-clinical-trials-as-topic #depressive-disorder #double-blind-method

St. John's wort for depression: a meta-analysis of well-defined clinical trials

Kim et al., 1999 | J Nerv Ment Dis | Meta Analysis

Citation

Kim H L, Streltzer J, Goebert D. St. John's wort for depression: a meta-analysis of well-defined clinical trials. J Nerv Ment Dis. 1999-Sep;187(9):532-8

Abstract

Studies concluding that St. John's wort (Hypericum perforatum) is an effective antidepressant can be challenged due to questionable methodology. We attempt to correct this by a meta-analysis utilizing only well-defined clinical trials. Controlled, double-blind studies using strictly defined depression criteria were analyzed by the rate of change of depression and by the number of "treatment responders." Rates of side effects and dropouts were also analyzed. Hypericum was 1.5 times more likely to result in an antidepressant response than placebo and was equivalent to tricyclic antidepressants (TCAs). The meta-analysis also showed that there was a higher dropout rate in the TCA group and that the TCAs were nearly twice as likely to cause side effects, including those more severe than hypericum. Hypericum perforatum was more effective than placebo and similar in effectiveness to low-dose TCAs in the short-term treatment of mild to moderately severe depression. However, design problems in existing studies prevent definitively concluding that St. John's wort is an effective antidepressant.

Key Findings

John's wort is an effective antidepressant.

Outcomes Measured

  • depression

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition depression

MeSH Terms

  • Adult
  • Antidepressive Agents, Tricyclic
  • Controlled Clinical Trials as Topic
  • Depressive Disorder
  • Double-Blind Method
  • Drug Administration Schedule
  • Ericales
  • Humans
  • Patient Dropouts
  • Phytotherapy
  • Placebos
  • Psychiatric Status Rating Scales
  • Research Design
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Comparative Study, Journal Article, Meta-Analysis
  • Vertical: st.-john's-wort

Provenance

  • PMID: 10496508
  • DOI: (not available)
  • PMCID: Not in PMC
  • Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09