St John's wort for depression: meta-analysis of randomised controlled trials

source extracted confidence: high 2026-04-09
#antidepressive-agents #depressive-disorder #humans #hypericum #phytotherapy

St John's wort for depression: meta-analysis of randomised controlled trials

Linde et al., 2005 | Br J Psychiatry | Meta Analysis

Citation

Linde Klaus, Berner Michael, ... Mulrow Cynthia. St John's wort for depression: meta-analysis of randomised controlled trials. Br J Psychiatry. 2005-Feb;186:99-107

Abstract

BACKGROUND: Extracts of Hypericum perforatum (St John's wort) are widely used to treat depression. Evidence for its efficacy has been criticised on methodological grounds. AIMS: To update evidence from randomised trials regarding the effectiveness of Hypericum extracts. METHODS: We performed a systematic review and meta-analysis of 37 double-blind randomised controlled trials that compared clinical effects of Hypericum monopreparation with either placebo or a standard antidepressant in adults with depressive disorders. RESULTS: Larger placebo-controlled trials restricted to patients with major depression showed only minor effects over placebo, while older and smaller trials not restricted to patients with major depression showed marked effects. Compared with standard antidepressants Hypericum extracts had similar effects. CONCLUSIONS: Current evidence regarding Hypericum extracts is inconsistent and confusing. In patients who meet criteria for major depression, several recent placebo-controlled trials suggest that Hypericum has minimal beneficial effects while other trials suggest that Hypericum and standard antidepressants have similar beneficial effects.

Key Findings

Larger placebo-controlled trials restricted to patients with major depression showed only minor effects over placebo, while older and smaller trials not restricted to patients with major depression showed marked effects. Compared with standard antidepressants Hypericum extracts had similar effects.

Outcomes Measured

  • depression

Population

Field Value
Population major depression showed only
Sample Size See abstract
Age Range See abstract
Condition depression

MeSH Terms

  • Antidepressive Agents
  • Depressive Disorder
  • Humans
  • Hypericum
  • Phytotherapy
  • Plant Extracts
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: st.-john's-wort

Provenance

  • PMID: 15684231
  • 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