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PubMed2000

[History of St. Johns wort].

St.-John's wort owes its name to the fact that it flowers at the time of the summer solstice on or around St. John's day on 24 June. Having been administered as a remedy by the Roman military doctor Proscurides as early as the 1st century AD, it was mainly used for magic potions during the Middle Ages. It was not only used to protect humans and animals against witches, demons and evil diseases, but it was also added to the fire when moulding "Freikugel" [1]. Paracelsus was one of the first doctors to concern themselves with St.-John's wort. However, where it had formerly been used for a plethora of indications, in more recent times it has found its place in the treatment of depression and anxiety disorders. In numerous clinical double-blind trials against placebo and other antidepressants the whole extract of St.-John's wort, e.g. as in Jarsin coated tablets, has proved to be just as effective as the other antidepressants for mild and moderate depression, but not for severe depression.

Animals↗
PubMed2000

[Mechanism of action of St. Johns wort extract].

Over the last few years St-John's wort preparations have been used in large quantities in Germany for treating mild to moderate depression. In the meantime the antidepressive action of these extracts has been proved in numerous placebo-controlled studies. Furthermore, a considerably lower adverse effect rate compared with classic antidepressants has been established. Analogously to other antidepressants, subchronic St-John's wort treatment of rats showed significant down-regulation of beta receptor density and a significant increase in 5HT2 receptors. The extract also exhibited antidepressant activity in animal pharmacological models of depression. Interest is now focused on identifying the underlying pharmacological mechanisms of action of this phytotherapeutic agent. Like other working parties, we were only able to identify a weak inhibitory effect of the extract and the pure substance hypericin on the monoamine oxidases A and B. Similarly to synthetic antidepressants, St-John's wort exerts marked inhibitory effects on synaptosomal uptake of serotonin and noradrenaline. However, dopamine and uptake and neuronal uptake of GABA and L-glutamate are also inhibited. These effects may mainly be attributed to the substance hyperforin contained in the extract. An additional, as yet unknown, pharmacological mechanism of action of St-John's wort extracts is beginning to emerge. Although hyperforin shows similar properties to classical antidepressants, there are indications of a novel mechanism of action. Our laboratory is currently investigating the means by which St-John's wort extract, or its constituent hyperforin, develops its antidepressant action.

Animals↗
PubMed2000

[Treatment of depression with St. Johns wort in general practice].

70-90% of depressive patients are treated by their own family doctors. Recognising and treating depression is an important daily problem for family doctors. The severity of the disorder decides whether non-pharmacological therapy or pharmacotherapy is preferable. The choice and dosage of an antidepressant is dictated by the severity and the symptomatology of the disorder as well as the expected adverse effects. Not least on account of their low rate of adverse effects, phytotherapeutic agents are enjoying growing popularity among patients and thus assure high compliance. The use of herbal preparations is useful, in particular for mild to moderate depression in young patients or patients with a reserved attitude toward "chemical drugs". Of all phytopharmaceuticals St.-John's wort has been most widely scientifically documented for the treatment of depression.

Adult↗
PubMed2000

[Treatment of dysthymia].

Hippocrates described both melancholy and dysthymia. An episode of mild depression lasting up to 2 years, which does not make patients unfit to work, although the repressive irritative mood disorder does reduce their ability to work. Severe depressive moods can develop from dysthymia. While dysthymia responds to antidepressant treatment similarly to depressive episodes, treatment must be carried out for a considerably longer period. The dosage dose not differ from that for severe depressive episodes. A few examples of cases are presented from the speaker's own cases to illustrate how well they responded to treatment with St.-John's wort.

Antidepressive Agents↗
PubMed2001

[Phytochemicals as means to induce sleep].

Phytopharmacons are widely used in Germany. Whereas St. John's wort extracts are prescribed for the treatment of mild forms of depression and kava-kava for unspecified anxiety syndromes, hop, balm, lavender, passiflora and valerian are traditionally administered against nervousness and sleep disturbances. Controlled clinical trials are only available for valerian. However, no sleep inducing potential of valerian was observed, only a certain positive effect on daytime mood. Therefore, the mentioned phytopharmacons cannot be recommended for the treatment of sleep disturbances.

Anxiety↗
PubMedDate not supplied

Nutraceuticals: sorting out fact, fiction, and uncertainty.

Scientific evaluation of herbal products has been limited, yet herbal products are the most commonly consumed health care products. Because of known pharmacological effects and potential interactions of many of these compounds with therapeutic drugs, a history of herbal and dietary supplement intake should be considered part of the routine medical history and should be evaluated before any changes in prescription drugs and before medical procedures.

Dietary Supplements↗