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Efficacy of St. John’s wort extract WS® 5570 in acute treatment of mild depression

A reanalysis of data from controlled clinical trials

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Abstract

Based on the original data from two double-blind, randomized, placebo-controlled clinical trials and the acute phase of a long-term study that investigated the antidepressant efficacy of St. John’s wort extract WS® 5570, we present a re-analysis of a subset of patients suffering from an acute episode of mild depression according to DSM criteria. Out of a total of more than 1,200 patients included into these trials 217 had a pre-treatment total score ≤20 points on the 17-item Hamilton Rating Scale for Depression (HAMD) and were eligible for our re-analysis. They received 600, 900, or 1,200 mg/day WS® 5570 or placebo for 6 weeks. In patients treated with WS® 5570 the HAMD total score decreased by averages of 10.8 (600 mg/day), 9.6 (900 mg/day), and 10.7 (1,200 mg/day) points between the pre-treatment baseline value and the end of acute treatment, compared to 6.8 points in the placebo group (p < 0.01 for all pairwise comparisons of WS® 5570 against placebo). This corresponded to average relative decreases by 49–57% for WS® 5570 and by 36% for placebo. The rates of responders (i.e., patients with a HAMD total score decrease ≥50%) were 73%, 64%, 71%, and 37% for WS® 5570 600 mg/day, 900 mg/day and 1,200 mg/day, and placebo, respectively. At the end of acute treatment 57% of the patients treated with WS® 5570 600 mg/day, 33% in the 900 mg/day group and 62% in the 1,200 mg/day group, as well as 25% in the placebo group were in remission (HAMD total score ≤7 points). The analysis shows that St. John’s wort extract WS® 5570 has a meaningful beneficial effect during acute treatment of patients suffering from mild depression and leads to a substantial increase in the probability of remission.

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Notes

  1. Manufacturer: Dr. Willmar Schwabe Pharmaceuticals, Karlsruhe, Germany.

References

  1. Angst J, Delini-Stula A, Stabl M, Stassen HH (1993) Is a cut-off score a suitable measure of treatment outcome in short-term trials in depression? A methodological meta-analysis. Hum Psychopharmacol: Clin Exp 8:311–317

    Article  Google Scholar 

  2. Dienel A, Kasper S, Kieser M (2005) Hypericum extract WS® 5570 has a beneficial effect in continuation treatment of recurrent depression. Pharmacopsychiatry 38:236

    Google Scholar 

  3. Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296

    PubMed  CAS  Google Scholar 

  4. Hirschfeld RM, Keller MB, Panico S, Arons BS, Barlow D, Davidoff F, Endicott J, Froom J, Goldstein M, Gorman JM, Marek RG, Maurer TA, Meyer R, Phillips K, Ross J, Schwenk TL, Sharfstein SS, Thase ME, Wyatt RJ (1997) The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. JAMA 277:333–340

    Article  PubMed  CAS  Google Scholar 

  5. Kalb R, Trautmann-Sponsel RD, Kieser M (2001) Efficacy and tolerability of hypericum extract WS 5572 versus placebo in mildly to moderately depressed patients. A randomized double-blind multicenter clinical trial. Pharmacopsychiatry 34:96–103

    Article  PubMed  CAS  Google Scholar 

  6. Kasper S, Anghelescu I, Szegedi A, Dienel A, Kieser M (2006) Superior efficacy of St John’s wort extract WS® 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial BMC Medicine

  7. Kasper S, Dienel A (2002) Cluster analysis of symptoms during antidepressant treatment with Hypericum extract in mildly to moderately depressed out-patients. A meta-analysis of data from three randomized, placebo-controlled trials. Psychopharmacology (Berl) 164:301–308

    Article  CAS  Google Scholar 

  8. Kasper S, Dienel A, Kieser M (2004) Continuation and long-term maintenance treatment with Hypericum extract WS® 5570 after successful acute treatment of mild to moderate depression–rationale and study design. Int J Methods Psychiatr Res 13:176–183

    Article  PubMed  CAS  Google Scholar 

  9. Kirsch I, Moore TJ, Scoboria A, Nicholls SS (2002) The Emperor’s New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration. Prevention and Treatment 5: http://www.journals.apa.org/prevention/volume5/pre0050023a.html

  10. Knüppel L, Linde K (2004) Adverse effects of St. John’s Wort: a systematic review. J Clin Psychiatry 65:1470–1479

    Article  PubMed  Google Scholar 

  11. Laakmann G, Schüle C, Baghai T, Kieser M (1998) St. John’s wort in mild to moderate depression: the relevance of hyperforin for the clinical efficacy. Pharmacopsychiatry 31(Suppl 1):545–549

    Google Scholar 

  12. Lecrubier Y (1998) Is depression under-recognised and undertreated? Int Clin Psychopharmacol 13(Suppl 5):S3–S6

    Article  PubMed  Google Scholar 

  13. Lecrubier Y, Clerc G, Didi R, Kieser M (2002) Efficacy of St. John’s wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial. Am J Psychiatry 159:1361–1366

    Article  PubMed  CAS  Google Scholar 

  14. Lépine JP, Gastpar M, Mendlewicz J, Tylee A (1997) Depression in the community: the first pan-European study DEPRES (Depression Research in European Society). Int Clin Psychopharmacol 12:19–29

    Article  PubMed  Google Scholar 

  15. Linde K, Berner M, Egger M, Mulrow C (2005) St. John’s wort for depression: meta-analysis of randomised controlled trials. Br J Psychiatry 186:99–107

    Article  PubMed  Google Scholar 

  16. Montgomery SA (1994) Clinically relevant effect sizes in depression. Eur Neuropsychopharmacol 4:283–284

    Article  CAS  Google Scholar 

  17. Nierenberg AA, DeCecco LM (2001) Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: a focus on treatment-resistant depression. J Clin Psychiatry 62(Suppl 16):5–9

    PubMed  CAS  Google Scholar 

  18. Szegedi A, Kohnen R, Dienel A, Kieser M (2005) Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St. John’s wort): randomised controlled double blind non-inferiority trial versus paroxetine. BMJ 330:503–506

    Article  PubMed  CAS  Google Scholar 

  19. Trautmann-Sponsel RD, Dienel A (2004) Safety of Hypericum extract in mildly to moderately depressed outpatients: a review based on data from three randomized, placebo-controlled trials. J Affect Disord 82:303–307

    Article  PubMed  CAS  Google Scholar 

  20. Wittchen HU, Pittrow D (2002) Prevalence, recognition and management of depression in primary care in Germany: the Depression 2000 study. Hum Psychopharmacol 17(Suppl 1):S1–11

    Article  PubMed  Google Scholar 

  21. Womack T, Potthoff J, Udell C (2001) Placebo response in clinical trials. What we can learn from antidepressant trials. Appl Clin Trials 10:32–44

    Google Scholar 

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Correspondence to S. Kasper MD.

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Kasper, S., Gastpar, M., Müller, W.E. et al. Efficacy of St. John’s wort extract WS® 5570 in acute treatment of mild depression. Eur Arch Psychiatry Clin Neurosc 258, 59–63 (2007). https://doi.org/10.1007/s00406-007-0779-2

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  • DOI: https://doi.org/10.1007/s00406-007-0779-2

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