Table 2 Evidence table
From: A systematic review of St. John’s wort for major depressive disorder
Study Details | Participants | Intervention |
|---|---|---|
Behnke, 2002 [17], Country: NR Funding: unclear, industry author, provided SJW | Number of participants: 70 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): 18–73 overall; 51.4 (10.9) SJW; 48.0 (12.6) fluoxetine, gender (% male): 29 % SJW; 34 % fluoxetine; (1 participant missing from SJW group) | Extract: Hypericum perforatum Dosage: 150 mg (0.450–0.495 mg total hypericin), 6 weeks Comparator: fluoxetine Follow-up time: 6 weeks |
Bernhardt, 1993 [16], Country: Germany Funding: unclear, not reported | Number of participants: 55 Diagnosis: clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): 54.5 (11.6), gender (% male): 29 % | Extract: hypericin Dosage: 0.25 mg extract/3 times per day (morning/noon/night), 4 weeks; Comparator: 0.25 mg extract/3 times per day (2 in the morning, 1 at noon) Follow-up time: 4 weeks |
Bjerkenstedt, 2005 [18], Country: Sweden Funding: no industry funding | Number of participants: 174 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): 49.1 (12.0) SJW; 50.4 (11.6) fluoxetine; 51.4 (11.8) placebo; gender (% male): SJW 20 %; fluoxetine 24 %: placebo 18 % | Extract: hypericum LI 160 Dosage: 300 mg, 3 times per day, daily, 4 weeks Comparator: fluoxetine, placebo Follow-up time: 4 weeks |
Brenner, 2000 [19], Country: USA Funding: no industry funding | Number of participants: 30 Diagnosis: MDD (DSM) and clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): 45; gender (% male): 37 % | Extract: LI 160 Dosage: 600 mg per day during week 1, followed by 900 mg per day for the remainder of the trial Comparator: sertraline Follow-up time: 7 weeks |
Fava, 2005 [20], Country: USA Funding: no industry funding | Number of participants: 135 Diagnosis: MDD (DSM), clinical rating scale for depression, other diagnosis, SCID Severity: moderate Age (years, M (SD)): 37.3 (11.0) Gender (% male): 43 % | Extract: LI 160 Dosage: 300 mg, 3 times a day Comparator: fluoxetine, placebo Follow-up time: 12 weeks |
Gastpar, 2005 [21] Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 241 Diagnosis: MDD (DSM), clinical rating scale for depression, MDD (ICD) Severity: moderate Age (years, M (SD)): 48.3 (12.7) SJW; 49.5 (13.8) sertraline Gender (% male): SJW 21 %; sertraline 31 % | Extract: STW3 Dosage: 612 mg/day/12 weeks Comparator: sertraline Follow-up time: 24 weeks |
Gastpar, 2006 [22], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 388 Diagnosis: MDD (DSM), clinical rating scale for depression, MDD (ICD) Severity: moderate Age (years, M (SD)): SJW 50.8 (12.1); citalopram 49.3 (10.7); placebo 49.4 (12.7) Gender (% male): SJW 34 %, citalopram 35 %, placebo 27 % | Extract: STW3-VI Dosage: 900 mg/day/6 weeks Comparator: citalopram, placebo Follow-up time: 6 weeks |
HDTSG, 2002 [23], Country: USA Funding: no industry funding | Number of participants: 338 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: not reported Age (years, M (SD)): SJW 43.1 (13.5); sertraline 43.9 (13.9); placebo 40.1 (12.2) Gender (% male): SJW 35 %; sertraline 33 %; placebo 34 % | Extract: LI 160 Dosage: 300 mg/3 times a day/8 weeks Comparator: sertraline, placebo Follow-up time: 8 weeks |
Hangsen, 1994 [48], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 108 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: not reported Age (years, M (SD)): 53.0 (7.5) SJW; 53.5 (10.3) placebo Gender (% male): SJW 42 %; placebo 32 % | Extract: LI 160 Dosage: 300 mg/3 times a day/6 weeks Comparator: placebo Follow-up time: 5 and 6 weeks |
Harrer, 1994 [24], Country: Germany Funding: unclear, not reported | Number of participants: 102 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: moderate Age (years, M (SD)): SJW 43.8 (13.4); maprotiline 47.6 (10.9) Gender (% male): SJW 25 %; maprotiline 31 % | Extract: LI 160 Dosage: 300 mg/3 times a day/4 weeks Comparator: maprotiline Follow-up time: 4 weeks |
Harrer, 1999 [25], Country: NR Funding: unclear, not reported | Number of participants: 228 Diagnosis: MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 68.4; fluoxetine 69.1 Gender (% male): 13 % | Extract: LoHyp-57 Dosage: 400 mg/two times a day/6 weeks Comparator: fluoxetine Follow-up time: 6 weeks |
Kalb, 2001 [26], Country: Germany Funding: industry funding | Number of participants: 72 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): SJW 48 (11); placebo 49 (10) Gender (% male): SJW 30 %; placebo 37 % | Extract: WS 5572 Dosage: 300 mg/3 times a day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Kasper, 2006 [27], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 332 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): SJW 600 mg 46.3 (11.5); SJW 1200 mg 46.1 (10.7); placebo 46.9 (11.8) Gender (% male): SJW 600 mg 44 %; SJW 1200 mg 34 %; placebo 31 % | Extract: WS 5570 Dosage: 600 or 1200 mg/day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Kasper, 2008 [28], Countries: Germany and Sweden Funding: industry funding | Number of participants: 570 Diagnosis: MDD (DSM), clinical rating scale for depression, MDD (ICD) Severity: mild Age (years, M (SD)): 47.5 (10.7); placebo 47.4 (11.8) Gender (% male): SJW 27 %; placebo 24 % | Extract: WS 5570 Dosage: 300 mg/3 times a day/26 weeks Comparator: placebo Follow-up time: 32 weeks |
Laakmann, 1998 [29], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 196 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): SJW WS 5572 47.3 (11.8); SJW WS 5573 48.7 (11.8); placebo 51.0 (12.7) Gender (% male): SJW WS 5572 18 %; SJW WS 5573 14 %; placebo 29 % | Extract: WS 5572; WS 5573 Dosage: 3 × 300 mg/day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Lecrubier, 2002 [30], Country: France Funding: industry funding | Number of participants: 375 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): SJW 40.2 (11.7); placebo 41.2 (11.4) Gender (% male): SJW 24 %; placebo 23 % | Extract: WS 5570 Dosage: 300 mg/3 times a day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Lenoir, 1999 [31], Countries: Switzerland and Germany Funding: unclear, industry author, provided SJW | Number of participants: 348 Diagnosis: MDD (ICD) Severity: mild-moderate Age (years, M (SD)): 19–94 (range) Gender (% male): 26 % | Extract: hypericin Dosage: 0.17 mg, 0.33 mg, or 1 mg/day (divided into 3 doses)/6 weeks Comparator: other doses of SJW |
Liu, 2010 [32], Country: China Funding: no industry funding | Number of participants: 170 Diagnosis: clinical rating scale for depression, other diagnosis, ISFC and WHO criteria Severity: not reported Age (years, M (SD)): SJW 67 (2.7); Deanxit 68 (2.8); psychotherapy 68 (3.0); placebo 67 (2.5) Gender (% male): 50 % | Extract: NA Dosage: 300 mg/3 times a day/12 weeks Comparator: Deanxit 10.5 mg/daily, cognitive therapy, suggestion therapy, supportive therapy and rational emotive therapy/twice per week, placebo (oryzanol 20 mg)/3 times a day Follow-up time: 12 weeks |
Mannel, 2010 [33], Country: Germany Funding: industry funding | Number of participants: 201 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 47.0 (13.1); placebo 46.6 (13.8) Gender (% male): 17 % | Extract: LI 160 Dosage: 300 g/2 times a day/8 weeks Comparator: placebo Follow-up time: 8 weeks |
Montgomery, 2000 [34], Country: UK Funding: unclear, not reported | Number of participants: 248 Diagnosis: MDD (DSM) Severity: mild-moderate Age (years, M (SD)): NA Gender (% male): NA | Extract: LI 160 Dosage: 300 mg/3 times a day/12 weeks Comparator: placebo Follow-up time: 6 weeks |
Moreno, 2005 [35], Country: Brazil Funding: industry funding | Number of participants: 66 Diagnosis: clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): 40.5 (10.7) Gender (% male): 17 % | Extract: NA Dosage: 300 mg/3 times a day/8 weeks Comparator: fluoxetine, placebo Follow-up time: 8 weeks |
Pakseresht, 2012 [36], Country: Iran Funding: no industry funding | Number of participants: 40 Diagnosis: clinical rating scale for depression, other diagnosis, diagnosed depression, method unspecified Severity: mild-moderate Age (years, M (SD)): SJW 29.8 (6.2); placebo 30 (16.6) Gender (% male): SJW 50 %; placebo 45 % | Extract: NA Dosage: 300 mcg/3 times a day/6 weeks Comparator: nortriptyline 75–100 mg, imipramine 100–150 mg, amitriptyline 100–150 mg/daily, placebo/daily Follow-up time: 6 weeks |
Philipp, 1999 [37], Country: Germany Funding: industry funding | Number of participants: 263 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: not reported Age (years, M (SD)): 47 (12) Gender (% male): 25 % | Extract: STEI 300 Dosage: 350 mg/3 times day/8 weeks Comparator: imipramine, placebo Follow-up time: 8 weeks |
Rahman, 2008 [38], Country: Pakistan Funding: industry funding | Number of participants: 225 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 33.89 (10.884); placebo 36.29 (12.478) Gender (% male): SJW 23 %; placebo 21 % | Extract: NA Dosage: 300 mg/3 times a day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Schrader, 1998 [40] Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 162 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 47 (32–59.25, 25–75 % range); placebo 39 (30–59.25, 25–75 % range) Gender (% male): SJW 28 %; placebo 38 % | Extract: ZE117 Dosage: 250 mg/2 times a day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Schrader, 2000 [39] Country: Germany Funding: industry funding | Number of participants: 240 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 46 (19); fluoxetine 47 (17) Gender (% male): SJW 29 %; fluoxetine 41 % | Extract: Ze 117 Dosage: 250 mg/2 times a day/6 weeks Comparator: fluoxetine Follow-up time: 6 weeks |
Shelton, 2001 [41], Country: USA Funding: unrestricted grant/industry funding but no conflict | Number of participants: 200 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: Mild-moderate Age (years, M (SD)): SJW 41.4 (12.5); placebo 43.3 (13.7) Gender (% male): SJW 35 %; placebo 37 % | Extract: NA Dosage: 300 mg/a day/8 weeks Comparator: placebo Follow-up time: 8 weeks |
Szegedi, 2005 [42], Country: Germany Funding: industry funding | Number of participants: 251 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: moderate-severe Age (years, M (SD)): SJW 49.0 (11.0); Paroxetine 45.5 (11.5) Gender (% male): SJW 30 %; paroxetine 32 % | Extract: WS 5570 Dosage: 300 mg–600 mg/3 time a day/6 weeks Comparator: paroxetine Follow-up time: 6 weeks |
Uebelhack, 2004 [43], Country: Germany Funding: unclear, not reported | Number of participants: 140 Diagnosis: MDD (DSM), clinical rating scale for depression, MDD (ICD) Severity: not reported Age (years, M (SD)): SJW 46.4 (12.5); placebo 43.3 (12.6) Gender (% male): SJW 30 %; placebo 36 % | Extract: STW 3-VI Dosage: 900 mg/day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Volz, 2000 [50], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 140 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: mild-moderate Age (years, M (SD)): 47 Gender (% male): 19 % | Extract: D-0496 (hypericin) Dosage: 250 mg/twice a day/6 weeks Comparator: placebo Follow-up time: 6–8 weeks |
Vorbach, 1997 [44], Country: Germany Funding: unclear, industry author, provided SJW | Number of participants: 209 Diagnosis: MDD (ICD) Severity: not reported Age (years, M (SD)): SJW 48.8 (12.0); imipramine 50.1 (11.8) Gender (% male): SJW 27 %; imipramine 25 % | Extract: LI 160 Dosage: 3 × 600 mg/day/6 weeks Comparator: imipramine Follow-up time: 6 weeks |
Wheatley, 1997 [45], Country: UK Funding: unclear, not reported | Number of participants: 165 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: Mild-moderate Age (years, M (SD)): SJW 42 (range: 20–64); Amitriptyline 38 (range: 24–65) Gender (% male): SJW 16 %; Amitriptyline 23 % | Extract: LI 160 Dosage: 300 mg/3 times a day/6 weeks Comparator: Amitriptyline Follow-up time: 6 weeks |
Witte, 1995 [49], Country: Germany Funding: unclear, not reported | Number of participants: 97 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: Not reported Age (years, M (SD)): 44.7 (10.9) SJW; 41.6 (12.5) placebo Gender (% male): SJW 31 %; placebo 37 % | Extract: psychotonin forte Dosage: 100–120 mg/2 times a day/6 weeks Comparator: placebo Follow-up time: 6 weeks |
Woelk, 2000 [46], Country: Germany Funding: unrestricted grant/industry funding but no conflict | Number of participants: 324 Diagnosis: clinical rating scale for depression, MDD (ICD) Severity: mild-moderate Age (years, M (SD)): SJW 46.5 (12.7); imipramine 45.4 (12.8) Gender (% male): SJW 29 %; imipramine 29 % | Extract: Ze 117 Dosage: 250 mg/2 times a day/6 weeks Comparator: imipramine Follow-up time: 6 weeks |
van Gurp, 2002 [47], Country: Canada Funding: unrestricted grant/industry funding but no conflict | Number of participants: 90 Diagnosis: MDD (DSM), clinical rating scale for depression Severity: not reported Age (years, M (SD)): SJW 40.9 (11.6); sertraline 39.1 (10.2) Gender (% male): SJW 36 %; sertraline 42 % | Extract: NR Dosage: 1–2 300 mg/3 times a day/12 weeks Comparator: sertraline Follow-up time: 12 weeks |