Hypericum in the Treatment of Seasonal Affective Disorders

Psychiatrische Universitätsklinik Bonn, Germany.
Journal of Geriatric Psychiatry and Neurology (Impact Factor: 2.24). 11/1994; 7 Suppl 1(6):S29-33. DOI: 10.1177/089198879400700109
Source: PubMed


Seasonal affective disorder (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn/winter and full remission in spring/summer. Light therapy (LT) has become the standard treatment of this type of depression. Apart from this, pharmacotherapy with antidepressants also seems to provide an improvement of SAD symptoms. The aim of this controlled, single-blind study was to evaluate if hypericum, a plant extract, could be beneficial in treating SAD patients and whether the combination with LT would be additionally advantageous. Patients who fulfilled DSM-III-R criteria for major depression with seasonal pattern were randomized in a 4-week treatment study with 900 mg of hypericum per day combined with either bright (3000 lux, n = 10) or dim (< 300 lux, n = 10) light condition. Light therapy was applied for 2 hours daily. We found a significant (MANOVA, P < .001) reduction of the Hamilton Depression Scale score in both groups but no significant difference between the two groups. Our data suggest that pharmacologic treatment with hypericum may be an efficient therapy in patients with seasonal affective disorder.

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    • "Hypericin has long been in use, at least from the time of ancient Greece (Tammaro and Xepapadakis, 1986), as an antidepressant due to its monoamine oxidase (MAO) inhibiting capacity, having effects similar to bupropion (Nahrstedt and Butterweck, 1997) and imipramine (Raffa, 1998). Potential uses of hypericin extend to improved wound healing, anti-inflammatory effects (Zaichikova et al., 1985), antimicrobial and antioxidant activity (Radulovic et al., 2007), sinusitis relief (Razinkov et al., 1989), and seasonal affective disorder (SAD) relief (Martinez et al., 1993). Hypericin also has remarkable antiviral activity against a number of viruses (Kusari et al., 2008). "

    Metabolomics, 02/2012; , ISBN: 978-953-51-0046-1
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    • "To date, three trials have been performed using herbal agents in SAD. Two open-label trials using SJW alone and SJW plus light therapy found there was a significant reduction of winter-provoked depression compared with placebo, although there was no statistical difference between the two treatments (Martinez et al., 1994; Wheatley, 1999). However, a more rigorous RCT using Ginkgo biloba extract PN 246 to prevent the onset of SAD in 27 people, found no difference between the active and placebo group as defined by Montgomery-Asberg depression rating scale (M-ADS) and VAS (Lingaerde et al., 1999). "
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    ABSTRACT: This paper reports a critical review of 27 herbal medicines and formulas in treating a broad range of psychiatric disorders (in addition to anxiety and depression), including obsessive-compulsive, seasonal affective, bipolar depressive, psychotic, phobic and somatoform disorders. Ovid Medline, Pubmed and the Cochrane Library were searched for pharmacological and clinical evidence of herbal medicines with psychotropic activity. A forward search of later citations was also conducted. Whilst substantial high-quality evidence exists for the use of kava and St John's wort in the treatment of anxiety and depression respectively, currently there is insufficient robust clinical evidence for the use of many other herbal medicines in psychiatric disorders. Phytotherapies which potentially have significant use in psychiatry, and urgently require more research are Rhodiola rosea (roseroot) and Crocus sativus (saffron) for depression; Passiflora incarnata (passionflower), Scutellaria lateriflora (scullcap) and Zizyphus jujuba (sour date) for anxiety disorders; and Piper methysticum (kava) for phobic, panic and obsessive-compulsive disorders. While depression and anxiety are commonly researched, the efficacy of herbal medicines in other mental disorders requires attention. The review addresses current issues in herbal psychotherapy: herbal safety, future areas of application, the relationship of herbal medicine with pharmaceuticals and the potential prescriptive integration of phytomedicines with synthetic psychotropic medicines. Particular attention is given to clinical and safety issues with St John's wort and kava.
    Phytotherapy Research 08/2007; 21(8):703-16. DOI:10.1002/ptr.2187 · 2.66 Impact Factor
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    • "A study in 20 patients indicates that St John's wort (Hypericum perforatum) may be helpful in treating SAD. An add-on therapy with bright light in 10 of these patients treated with hypericum did not lead to a significantly better treatment outcome.59 Two studies in 6 patients each report beneficial effects of the benzodiazepine alprazolam.56,60 "
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    ABSTRACT: Seasonal affective disorder (SAD) is a subform of major depressive disorder, recurrent, or bipolar disorder with a regular onset of depressive episodes at a certain time of year, usually the winter. The treatment of SAD is similar to that of other forms of affective disorder, except that bright light therapy is recommended as the first-line option. Light therapy conventionally involves exposure to visible light of at least 2500 lux intensity at eye level. The effects of light therapy are thought to be mediated exclusively by the eyes, not the skin, although this assumption has not yet been verified. Morning light therapy has proven to be superior to treatment regimens in the evening. Response rates to light therapy are about 80% in selected patient populations, with atypical depressive symptoms being the best predictor of a favorable treatment outcome. Data from randomized, controlled trials suggest that antidepressants are effective in the treatment of SAD. Three double-blind, placebo-controlled trials have been conducted showing promising results for the selective serotonin reuptake inhibitors (SSRIs) sertraline and fluoxetine, as well as for moclobemide, a reversible inhibitor of monoamine oxidase A.
    Dialogues in clinical neuroscience 12/2003; 5(4):389-98.
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