Changes

*Depression : Numerous studies in Europe, and more recently in the United States, have found that St. John’s wort is more effective than a placebo and as effective as tricyclic antidepressants for the short-term treatment (1 to 3 months) of mild to moderate depression. It appears to cause fewer side effects than many antidepressants, which is one of the main reasons it has become so popular. At least two recent studies, however, didn’t find St. John’s wort to be more effective than a placebo for major depression. Some experts consider the studies to be flawed, due to inadequate dosages and an insufficient number of participants, which led to unusual results. For example, in one of the studies, the prescription antidepressant sertraline (Zoloft) had no effect on major depression. Another study found that St. John's wort was more effective than fluoxetine (Prozac) but not a placebo. The evidence for St. John's wort for major depression remains unclear. Until we have evidence that it works for severe depression, it should not be used as a substitute for proven treatments. A study involving 150 people with minor depression or dysthymia found that St. John's wort was effective for minor depression (Hamilton Depression Scale score of up to 17), but that it wasn’t effective for people with dysthymia. *Anxiety : St. John's wort is also being studied for anxiety because, in some studies on depression, people taking St. John's wort also reported an improvement in anxiety. More research is needed. *Obsessive Compulsive Disorder (OCD) : St. John’s wort has also been suggested as a possible treatment for OCD because the same medications (antidepressants) are often used for OCD, and because of promising results from a preliminary study. A later study on St. John's wort, however, didn’t find it more effective than a placebo for OCD. *Skin Conditions : Oil of St. John's wort, applied to the skin, was a folk remedy for skin injuries, nerve pain, burns and hemorrhoids. Although the oil is sold in some herbal stores, creams are also available. Some are standardized to hypericin or hyperforin, which are thought to have anti-inflammatory and antibacterial effects. St. John's wort also contains tannins, naturally occurring compounds thought to relieve skin irritations, such as those resulting from minor cuts. *Ear Pain : Some alternative practitioners recommend St. John's wort for ear pain due to an ear infection (otitis media). In a study of more than 100 children, a combination herbal ear drop that contained St. John's wort, garlic, calendula and mullein was found to be as effective as conventional ear drops. *Smoking Cessation : St. John's wort is being explored for smoking cessation. Although promising, well-designed studies are needed. *Other Conditions : St. John's wort has also been explored for conditions that can have psychological symptoms, such as insomnia, menopausal symptoms, premenstrual syndrome, seasonal affective disorder and attention deficit disorder. Further studies are needed before recommendations can be made.