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| EVIDENCE FOR EFFICACY (HUMAN DATA) |
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Clinical Trials
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Results of a pilot double-blind, randomized clinical trial suggest Hypericum perforatum may improve quality of life of symptomatic perimenopausal women, but these results need to be confirmed by a larger clinical trial.
Al-Akoum 2009
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Human trial found depressive symptoms improved both with antidepressants (fluoxetine, duloxetine or Hypericum perforatum) and placebo, but melatonin changes could only be seen in those taking antidepressants; it is suggested this is due to pharmacological action.
Carvalho 2009
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Systematic review examines information relating to the effectiveness and safety of 20 interventions including sertraline, St John's Wort, tricyclic antidepressants, and venlafaxine used in treatment of depression in children and adolescents.
Hazell 2009
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A study carried out to determine whether exposure to St. John's Wort in human pregnancy is associated with major malformations indicates evidence of fetal safety.
Moretti 2009
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Administration of a St. John's wort product with low hyperforin content in 20 healthy volunteers for 2 weeks resulted in a mild induction of CYP3A not considered clinically relevant.
Mueller 2009
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The absolute quit rates, the small difference between active and placebo, and lack of effects on withdrawal shows that St. John's Wort is ineffective for smoking cessation.
Parsons 2009
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Meta-analysis to compare the efficacy and tolerability of Hypericum perforatum with selective serotonin reuptake inhibitors (SSRI) found Hypericum does not differ from SSRIs according to efficacy and adverse events in management of major depressive disorders.
Rahimi 2009
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The first randomised controlled trial using a combination of St. John's wort and Kava for treatment of major depressive disorder with co-morbid anxiety in 28 adults found some evidence of antidepressant effects.
Sarris 2009
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Results of randomized controlled trial of phytotherapeutic intervention comprising a combination of Hypericum perforatum and Vitex agnus-castus suggests the combination may be effective for the management of PMS-like symptoms in perimenopausal women.
van Die 2009
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The herbal combination of Hypericum perforatum and Vitex agnus-castus was not found to be superior to placebo for the treatment of menopausal symptoms. The herbal combination was well tolerated with no significant adverse events noted in the short term.
van Die 2009
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Review of evidence on the benefits and risks of CAM for the treatment of patients with major depressive disorders found, among other results, that best evidence supports the use of Hypericum perforatum for the treatment of mild to moderate depression.
Andreescu 2008
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Six botanical extracts including Hypericum perforatum were evaluated in 3 separate studies (2 extracts per study), each incorporating 16 healthy volunteers. Only goldenseal revealed significant inhibition (approx. 50%) of CYP2D6.
Gurley 2008
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Review of wide range of herbal formulations, such as St. John's wort, that have been analyzed in clinical trials to estimate their value in treating mental conditions including mood and anxiety disorders.
Jarema 2008
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The efficacy of photodynamic therapy with topical application of hypericin in actinic keratosis, basal cell carcinoma and morbus Bowen (carcinoma in situ) was investigated with 34 patients--eight with actinic keratoses with inconclusive results.
Kacerovsk?008
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Meta 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.
Kasper 2008
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A double-blind, placebo controlled multicenter trial of the efficacy & safety of Hypericum extract WS 5570 showed a beneficial effect in preventing relapse after recovery from acute depression. Tolerability in continuation and long-term maintenance treatment was same as placebo.
Kasper 2008
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The history of the Cochrane systematic review on St. John's wort (Hypericum perforatum L.) for depression from 1993 to 1996 is described. [Article in German]
Linde 2008
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Systematic review evidence suggests that the hypericum extracts tested in the included trials are superior to placebo in patients with major depression, are equally effective as standard antidepressants and have fewer side effects than standard antidepressants.
Linde 2008
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A phase III monocentre randomized placebo controlled study of homeopathic complex (Arnica montana 5 CH, Bryonia alba 5 CH, Hypericum perforatum 5 CH & Ruta graveolens 3 DH) was not found superior to placebo in reducing 24 h morphine consumption after knee ligament reconstruction.
Paris 2008
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A single-center, randomized, double-blind, prospective study with 18 volunteers confirms the different skin-irritating potential of bath oils and demonstrates good skin tolerance of a new bath oil containing St. John's wort extract.
Reuter 2008
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A double-blind, randomized, placebo-controlled, single-center study evaluating effects of Hypericum perforatum extract failed to show alleviation of pain in 39 patients with burning mouth syndrome, although reduction in number of sites with reported burning sensation was significant.
Sardella 2008
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Recent empirical studies of herbal and dietary treatments including the use of omega-3 fatty acids, St John's wort, dietary manipulations, kava, gingko and lemon balm for psychiatric disorders in children and adolescents was examined.
Soh 2008
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In a randomized, double-blind, placebo-controlled trial use of H. perforatum for treatment of ADHD over the course of 8 weeks did not improve symptoms.
Weber 2008
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Potential pharmacokinetic and pharmacodynamic interactions between St John's wort and gliclazide in healthy subjects with different cytochrome P450 2C9 genotypes was assessed.
Xu 2008
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The effect of treatment with a St. John's wort product (Movina) on cholesterol and triglyceride levels in 16 patients with hypercholesterolemia on treatment with a stable dose of atorvastatin found an interaction between the studied St. John's wort product and atorvastatin.
Andr?2007
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Among 1057 patients presenting for anaesthesia, 9% were taking one or more herbal remedies, including St John's wort, known to interact with the perioperative period. [Article in French]
Baillard 2007
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In vivo platelet function was not affected by the administration of any 5 herbal agents (Ginkgo biloba, garlic, Asian ginseng, St. John's wort, and saw palmetto) in 10 adult volunteers and was markedly inhibited with the administration of aspirin.
Beckert 2007
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St. John's wort administration in eight male subjects for 21 days had no apparent clinically important impact on the single-dose pharmacokinetic parameters of S(+)- and R(-)-ibuprofen.
Bell 2007
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Evaluation of the usage pattern, effectiveness and safety of black cohosh alone or in fixed combination with St. John's wort on menopausal symptoms in general clinical practice shows that the fixed combination is superior to black cohosh alone in alleviating climacteric mood symptoms.
Briese 2007
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Black cohosh and St. John's wort combination was found to be effective in alleviating climacteric symptoms in 89 peri- or postmenopausal women and might provide benefits to lipid metabolism.
Chung 2007
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A controlled, randomized, open, crossover pharmacodynamic study conducted in two primary healthcare centres revealed that products containing St John's Wort should not be given to patients with hypercholesterolemia who are on treatment with simvastatin.
Eggertsen 2007
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Placebo controlled continuation treatment with Hypericum extract WS 5570 in a doses of 600 mg/day or 1200 mg/day after recovery from a mild or moderate depressive episode was carried out.
Kasper 2007
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Hypericum was an effective antidepressant in patients with a pre-treatment score of 12 or more (n=208) on the Ham D(6), the effect size was 0.46. No difference with placebo was observed for those with a score of less than 12 (n=167).
Lecrubier 2007
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[St. John's wort may diminish methylphenidate's efficacy in treating patients suffering from attention deficit hyperactivity disorder.]
Niederhofer 2007
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Data were obtained from three randomised, placebo-controlled cross-over studies in 93 patients testing the effect of different drugs on polyneuropathic pain (St. John's wort, venlafaxine/imipramine and valproic acid).
Otto 2007
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A double-blind study comparing Hypericum perforatum, fluoxetine or placebo on 39 MDD outpatients who responded following a 12-week trial found earlier as well as early clinical improvement during treatment is predictive of greater symptom resolution at endpoint.
Papakostas 2007
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A clinical study showed that Hypericum extract WS 5570 & paroxetine were similarly effective in preventing relapse in a continuation treatment after recovery from moderate to severe depression, thereby indicating an alternative treatment option for long-term relapse-prevention.
Anghelescu 2006
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A preliminary clinical study 28 smokers of 10 or more cigarettes per day for at least one year has not provided convincing evidence that a St John's wort herb extract plus individual motivational/behavioural support is likely to be effective as an aid in smoking cessation.
Barnes 2006
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A systematic review of randomized controlled trials on St. John's Wort (SJW) and the treatment of mild to moderate depression demonstrated a drop in the Hamilton Depression Rating Scale scores for clients taking SJW compared with placebo or pharmaceutical antidepressants.
Clement 2006
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In women using oral contraceptive pills (OCPs) and St. John's wort (SJW) simultaneously, it appears that SJW does not interfere with the antiandrogenic properties of OCPs.
Fogle 2006
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Hypericum perforatum may enhance salivary cortisol via a U-shaped dose-response relationship in 20 healthy male volunteers which may be mediated through a 5-HT2 mechanism.
Franklin 2006
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The quality of reporting of randomized controlled trials of herbal medicine interventions including echinacea, ginkgo, St. John's wort, and kava have been reviewed.
Gagnier 2006
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A double-blind, randomised, placebo-controlled, multicentre clinical study reveals that St John's wort is a good alternative to chemically defined antidepressants in the treatment of 388 outpatients with moderate depression.
Gastpar 2006
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S-warfarin concentration and response data from healthy subjects who received a single warfarin dose (25 mg) and either St John's wort, Asian ginseng, Ginkgo biloba, or ginger found none of the herbs studied had a direct effect on warfarin pharmacodynamics.
Jiang 2006
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Hypericum perforatum extract WS 5570 at doses of 600 mg once daily and 600 mg twice daily were found to be safe in 332 patients and more effective than placebo, with comparable efficacy of the WS 5570 groups for the treatment of mild to moderate major depression.
Kasper 2006
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Standardized St. John's Wort as 450 mg capsules twice daily in 37 smokers, exhibited feasibility for use in smoking cessation.
Lawvere 2006
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In the analyses of 72 outpatients with mild to moderate depression, patients receiving Hypericum perforatum had the lowest remission rates compared to fluoxetine (34.6%) and placebo (45%).
Moreno 2006
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It was found in a study conducted on 42 male, healthy volunteers who were administered St. John's wort & hyperforin that the extent of induction of CYP3A varies with St. John's wort products and also depends on hyperforin dose.
Mueller 2006
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Hypericum extract LI160 has demonstrated a ketamine-antagonising effect and it is examined whether LI160 reverses changes of a low dose ketamine on auditory evoked potentials in healthy subjects.
Murck 2006
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Only in a secondary analysis, pooling of both lower (0.12%) or a higher (0.18%) hypericine formulation treated groups showed that Hypericum has a clinical significant effect in minor depressed patients with HAM-D up to 17 and the finding was significant only in non-dysthymic patients.
Randlov 2006
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The effect of two different hypericum extracts (STW 3, STW 3-VI) on photosensitivity with respect to minimal erythema dose (MED) after 14 days treatment was investigated by open, multiple-dose & one-phase studies which were conducted in 20 healthy men, receiving one tablet/day.
Schulz 2006
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Of the 100 participants with eating disorder symptoms 64% used an herbal product including Dexatrim and St. John's Wort for weight loss and they had the highest reported use.
Steffen 2006
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Enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses of single-herb interventions.
Walker 2006
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The pharmacokinetic interaction between a low-hyperforin St John's wort extract and alprazolam, caffeine, tolbutamide, and digoxin was evaluated in 28 healthy volunteers.
Arold 2005
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Comparision of efficacy of Hypericum LI 160 (H LI 160) to fluoxetine & placebo in a 4-week randomized, double-blind trial with 163 patients revealed that H LI 160 or fluoxetine were not more effective in short-term treatment in mild to moderate depression than placebo.
Bjerkenstedt 2005
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Recent clinical studies, have reported potential therapeutic effects for hypericum in the treatment of smoking cessation, for prickly pear extract in the prevention of alcohol hangover and magnesium supplementation as an adjunct to methadone treatment.
Dean 2005
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[St John's wort is at least as effective as paroxetine in reducing severity of depression and is better tolerated.]
Ernst 2005
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The presence of early improvement on the 17-item Hamilton Rating Scale for Depression concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with hypericum treatment but not with placebo.
Farabaugh 2005
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Comparision of antidepressant efficacy and safety of a standardized extract of St John's wort with both placebo & fluoxetine in patients with major depressive disorder revealed that St John's wort was significantly more effective than fluoxetine & showed a trend toward superiority over placebo.
Fava 2005
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Review on the effectiveness(EFNS) of treatments for depression in older people reveals that there is limited evidence to support the EFNS of transcranial magnetic stimulation, dialectical behaviour therapy, interpersonal therapy,light therapy, St John's wort & folate in reducing depressive symptoms.
Frazer 2005
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Hypericum extract STW 3 at a dose of 612 mg once daily for up to 24 weeks in 123 patients with moderate depression is not inferior to sertraline and it is a well-tolerated drug for the treatment of moderate depression.
Gastpar 2005
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A substantial fraction of the 594 patients treated with Hypericum extracts WS(R) 5570/5572 showed a meaningful reduction of depressive symptoms during the first two weeks of treatment, which was found to be a sensitive predictor of sustained response.
Kieser 2005
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A double-blind study of St John's wort versus placebo in obsessive-compulsive disorder (OCD) with 60 subjects fail to support the efficacy of St John's wort for OCD.
Kobak 2005
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The results from a placebo-controlled pilot study with 40 subjects failed to provide evidence for the efficacy of St. John's wort in social phobia.
Kobak 2005a
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St. John's wort has been found to be superior to placebo and equivalent to standard antidepressants for the treatment of mild to moderate depression.
Lawvere 2005
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Performance of a systematic review and meta-analysis of 37 double-blind randomised controlled trials reveals that Hypericum has minimal beneficial effects while other trials suggest that Hypericum and standard antidepressants have similar beneficial effects.
Linde 2005a
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Update of 1998 Cochrane evidence-based review of SJW for depression found that the tested extracts seem more effective than placebo and similarly effective as standard antidepressants for treating mild to moderate depressive symptoms. Beneficial effects for treating major depression appear minimal.
Linde 2005b
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An exploratory subgroup analysis of a three-armed study to compare Hypericum extract, fluoxetine, and placebo in 135 patients with major depressive disorder in a 12 week trial was performed.
Murck 2005
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Coadministration of St. John's wort leads to a short-term but clinically irrelevant increase followed by a prolonged extensive reduction in voriconazole exposure in 16 healthy men stratified for CYP2C19 genotype.
Rengelshausen 2005
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St John's wort is well tolerated in 26 patients and may be clinically effective in the treatment of some adolescents with mild depression.
Simeon 2005
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In the treatment of moderate to severe major depression in 251 adult outpatients, hypericum extract WS 5570 was at least as effective as paroxetine and was better tolerated.
Szegedi 2005
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Lack of herbal supplement characterization in published randomized controlled trials evaluating single-herb preparations of echinacea, garlic, ginkgo, saw palmetto, or St. John's wort has been reviewed.
Wolsko 2005
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[CYP3A and P-glycoprotein activity induction with St. John's Wort in healthy volunteers from 6 ethnic populations.]
Xie 2005
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The clinical effect of administering sufficient Hypericum perforatum to cattle to deliver quadruple the reported oral toxic dose was investigated which revealed that the reported bovine oral toxic dose of narrow leaved flowering stage biotype, H. perforatum was 3 g dried plant/kg body weight.
Bourke 2004
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A review on several integrative treatments for depression, including omega-3 fatty acids, Hypericum perforatum (St. John's Wort), S-adenosyl-methionine, folate, 5-Hydroxytryptophan, acupuncture, exercise, & light therapy, with emphasis on issues pertinent to women has been evaluated.
Freeman 2004
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During antidepressant treatment with 17 subjects, mean scores on the Hamilton Rating Scale for Depression for phase 1 nonresponders decreased significantly (p <.0001), with no significant difference between St. John's wort nonresponders and placebo nonresponders.
Gelenberg 2004
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The efficacy of St. John's wort (SJW) extract as a treatment for premenstrual symptoms was investigated as a randomized, double-blinded, placebo-controlled trial, with two parallel treatment groups which showed that there was a trend for SJW to be superior to placebo..
Hicks 2004
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In a placebo-controlled, double blind study, using 33 healthy volunteers it was found that Hypericin and pseudohypericin pharmacokinetics were only marginally influenced by comedication with the enzyme inhibitors and inducers cimetidine and carbamazepine.
Johne 2004
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A study on150 patients aged > or = 18 yearsrevealed that unrecognized use of St John's wort is frequent and may have an important influence on the effectiveness and safety of drug therapy during hospital stay.
Martin-Facklam 2004
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Investigation of St. John's wort (SJW) on pharmacokinetics of theophylline in 12 healthy Japanese male volunteers showed that SJW caused no changes in pharmacokinetics of theophylline in plasma and SJW administration tended to increase ratio of 1U/the total amount excreted in urine.
Morimoto 2004
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Administration of 600 mg of St. John's wort extract LI 160 daily in 184 outpatients was found to be effective and safe in the treatment of somatoform disorders.
Muller 2004
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A randomised double-blind crossover study was performed with 19 healthy subjects to examine the effects of Hypericum extract (LI160) on intravenously administered cortisol on auditory evoked potentials (AEPs) and salivary cortisol concentration.
Murck 2004
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Compared to synthetic antidepressants St. John's Wort demonstrated similar effectiveness and in the sub-group of mild to moderate depression, the herbal antidepressant showed better results against the synthetic antidepressants. [Article in German]
Roder 2004
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A post-marketing surveillance was conducted to investigate if the single-dose-administration of highlydosed St. John's Wort extract improves quality of life. [Article in German]
Rudolf 2004
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In a double-blind, randomized, placebo-controlled, crossover study, with 16 healthy subjects, it is found that St John's wort had no effect on blood pressure, heart rate, heart rate variability, or blood pressure variability.
Schroeder 2004
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The effects of acute oral administration of high-dose Hypericum perforatum extract WS 5570 on the cortisol (COR), adrenocorticotropic hormone (ACTH), growth hormone (GH), and prolactin (PRL) secretions were examined in 12 healthy male volunteers.
Schule 2004
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The randomized, double-blind, placebo-controlled study showed that St. John's wort extract had no effect on vasoconstrictory response of cutaneous blood flow and skin conductance response in healthy volunteers.
Siepmann 2004
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Hypericum extract STW 3-VI in a once-daily dosing regimen may be an effective and well-tolerated option for 140 outpatients with moderate depressive disorders.
Uebelhack 2004
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Clinical trial with 12 healthy adult men indicates that St. John's wort was an inducer to the human CYP2C19.
Wang 2004a
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Meta-analysis to reevaluate the effectiveness of St. John's wort as an antidepressant, funnel plot analysis, and meta-regression to assess the impact of publication bias, small-study effects, and variation in trial characteristics were performed.
Werneke 2004
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Survey of prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio in 747 families reveals that a total of 45.6% were taking some form of psychotropic agent (including St. John's wort and melatonin).
Aman 2003
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Administration of St. John's wort extract to renal transplant patients receiving cyclosporin A (CSA) treatment resulted in a rapid and significant reduction of plasma CSA concentrations.
Bauer 2003
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A survey of herbal use in children with attention-deficit-hyperactivity disorder or depression shows that herbal medicines were given most frequently for a behavioral condition, with ginkgo biloba, echinacea, and St. John's wort most prevalent.
Cala 2003
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Primary care patients experiencing common menopausal symptoms are likely to use 4 herbal products including St. John's wort, Ginkgo biloba, and ginseng that are purported to provide menopause symptom relief, and many believe that these products improve their menopausal symptoms.
Dailey 2003
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The effects of 12 days' pretreatment with St John's wort on the disposition of selected in vivo probe drugs were determined in 21 young healthy subjects.
Dresser 2003
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An open-label pilot study of St. John's wort in juvenile depression indicate that St. John's wort may be an effective treatment for youths diagnosed with major depressive disorder.
Findling 2003
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A prospective, observational, cohort study was conducted to examine the safety of St. John's wort to 33 nursing mothers and their infants, provided a framework for the management of breastfeeding women receiving St. John's wort.
Lee 2003
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In the evaluation of drug therapy knowledge in liver transplant patients after pharmacy counseling, two women were identified as regularly using St John's Wort and were informed that this herbal medicine can endanger the success of organ transplantation. [Article in French]
Monnier 2003
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It is proved that the symptoms associated with anxiety that severely afflict patients can be clearly improved more quickly with a combination therapy of St John's wort extract and valerian extract than with St John's wort monotherapy.
Muller 2003
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A randomized controlled trial on interaction of St John's wort with low-dose oral contraceptive(LDOC) therapy in 18 healthy females showed that there was no evidence of ovulation during LDOC and St John's wort extract combination therapy, but intracyclic bleeding episodes increased.
Pfrunder 2003
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The efficacy of a cream containing Hypericum extract standardised to 1.5% hyperforin in comparison to the corresponding vehicle (placebo) for the treatment of subacute Atopic Dermatitis was assessed in 21 patients.
Schempp 2003
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The effect of Hypericum extract LI 160 on skin sensitivity to ultraviolet B (UVB), ultraviolet A (UVA), visible light (VIS) and solar simulated radiation was investigated in 72 volunteers of skin types II and III.
Schempp 2003a
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Hypericum cream was found to be significantly superior to its vehicle in the topical treatment of mild to moderate atopic dermatitis in 21 patients. [Article in German]
Schempp 2003a
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Hypericum preparation found to be therapeutically equivalent to fluoxetine and is therefore a rational alternative to synthetic antidepressants.
Behnke 2002
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[Efficacy of continuation treatment with hypericum perforatum in depression.]
Brenner 2002
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[St John's wort was not better than placebo for reducing depression scores.]
Hawley 2002
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St John's wort increased expression and enhanced the drug efflux function of the multi drug transporter P-glycoprotein in peripheral blood lymphocytes of healthy volunteers.
Hennessy 2002
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St. John's wort extract may induce cytochrome P-450 enzymes or drug transporters (P-glycoprotein).
Johne 2002
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The results of meta-analysis indicate that Hypericum extract accelerated the recovery from depression in a rather general manner, by influencing all investigated signs and symptoms of the disease in 544 out-patients suffering from mild to moderate depression.
Kasper 2002
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Individuals harboring the *0/*0 genotype of glutathione-S-transferases mu 1 and theta 1 showed enhanced UVB-induced cutaneous damage after administration of Hypericum extract and GST genotypes modulated Hypericum-induced photosensitization.
Kerb 2002
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H. perforatum extract was found to be safe and more effective than placebo for the treatment of mild to moderate depression.
Lecrubier 2002
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It is reported that in a double-blind, placebo-controlled, randomized study the subjects receiving a combination of Citrus aurantium, caffeine and St John's Wort, lost significant amounts of total body weight while on a strict diet and exercise.
Preuss 2002
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Review finds doses of 500-1000 mg of extract per day of preparations of St. John's Wort are of comparable efficiency to synthetic antidepressants in their normally prescribed dosages.
Schulz 2002
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[St John's wort for the treatment of depression.]
Shelton 2002
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Multiple doses of St John's wort extract do not affect heart rate variability nor cognitive function.
Siepmann 2002
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Significantly more side effects were reported with the sertraline than with H. perforatum but no important differences in changes in mean Ham-D and BDI scores (using intention-to-treat analysis), with and without adjustment for baseline demographic characteristic.
van Gurp 2002
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A multicentre, randomised, 6-week trial was carried out to compare efficacy of St John's wort extract (LI 160) (600 mg/day) & placebo in 151 out-patients suffering from somatization disorder (ICD-10: F45.0), undifferentiated somatoform disorder (F45.1), or somatoform autonomic dysfunctions (F45.3).
Volz 2002
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A single dose of St John's wort resulted in significant inhibition of intestinal P-glycoprotein. Long-term treatment with St John's wort reversed changes in fexofenadine disposition observed with single-dose administration.
Wang 2002
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Hypericum, an antidepressant and antiviral medicine, was reported in 23 randomized clinical trials and found to be significantly more effective than placebo and had a similar level of effectiveness as standard antidepressants. [Article in Hebrew]
Boniel 2001
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Hypericum does not have an acute nootropic effect in healthy humans at doses of 900 mg and 1800 mg but showed some impairing effect on accuracy of numeric working memory and delayed picture recognition at the higher dose.
Ellis 2001
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H. perforatum extract may effect plasma hormonal changes via both 5-HT and DA-mediated mechanisms but do not involve noradrenaline, and hyperforin may be more important than hypericin for effecting these changes.
Franklin 2001
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St. John's wort extract is equivalent to fluoxetine in treating depression and anxiety symptoms, with better safety and tolerability data.
Friede 2001
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Hypericum is a potentially safe and effective treatment for children with symptoms of depression with good tolerability and no adverse events displayed.
Hubner 2001
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Hypericin given orally in doses of 0.05 and 0.10 mg/kg/d caused considerable phototoxicity and had no detectable anti-HCV activity in patients with chronic HCV infection.
Jacobson 2001
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A review showing that Safety and tolerability studies have revealed that St. John's wort preparations have better safety and tolerability profiles than synthetic antidepressants.
Kasper 2001
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Evaluation of tissue regenerating action of a mixture of oily extracts of Hypericum perforatum and Calendula arvensis on surgical wounds from childbirth with caesarean section.
Lavagna 2001
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The examination of effectiveness & tolerability of an extract of herba hyperici WS 5572 in multi-centre study with 2,166 patients, suffering from mild to moderate depression, shows its effectiveness & tolerability in patients suffering from mild & moderate depressive episodes. [Article in German]
Rychlik 2001
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Otikon Otic Solution, a naturopathic herbal extract containing Allium sativum, Verbascum thapsus, Calendula flores, and H. perforatum in olive oil, is as effective as Anaesthetic ear drops and shown to be appropriate for the management of AOM-associated ear pain.
Sarrell 2001
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Hypericum extract is able to influence central neurotransmitters, thereby causing COR stimulation in a dose-dependent manner.
Schule 2001
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St John's wort was safe and well tolerated but not effective for treatment of major depression.
Shelton 2001
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St. John's wort has no significant effect on pain in polyneuropathy.
Sindrup 2001
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Hypericum had neutral effects on performance of psychological tests but showed a dose-related impairment on digit symbol substitution test.
Timoshanko 2001
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Long-term SJW administration resulted in significant and selective induction of CYP3A activity of intestinal wall, but did not alter the CYP2C9, CYP1A2, or CYP2D6 activities.
Wang 2001
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Meta-analysis showed St John's wort to be significantly more effective than placebo but not significantly different in efficacy from active antidepressants.
Whiskey 2001
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"Antidepressive therapy. Hypericum extract Ll 160 highly effective " (German, no abstract)
anon 2000
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50% reduction in depression scores (HAM-D & CGI) in 47% of the hypericum group (900 mg/d LI 160) and 40% of the sertraline/Zoloft group (75 mg/d) in a 7 week study with 28 mild to moderate depressed patients
Brenner 2000
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Treatment with SJW for 14 days did not further induce the clearance of carbamazepine.
Burstein 2000
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Early detection of bladder cancer by red hypericin fluorescence using 40 ml. of a 8 muM. solution which lasted 16 hours and gave 93% sensitivity and 98.5% specificity for detecting carcinoma in 40 patients
D'Hallewin 2000
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The most recommended herb by both medical doctors & naturopaths was echinacea, followed by St John's Wort; in a survey of 242 practitioners
Einarson 2000
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Exponential mixed-effects model of curve fitting for the results of antidepressant trials with an example from a placebo-controlled study with St. John's Wort
Friede 2000
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Review found response rate of depression treated with St John's Wort was 23-55% higher than placebo, but 6-18% lower than tricyclic antidepressants. Rates of side effects were low, only 2.4% of 3250 patients, most commonly nausea (0.6%)
Gaster 2000
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"Study provides additional support for hypericum extract " (news, no abstract)
Miller 2000
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"Current pharmacologic therapy of depression " (German review, no abstract)
Moller 2000
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Treatment with SJW for 14 days resulted in significant increases in the urinary 6-beta-hydroxycortisol/cortisol ratio suggesting that it induces CYP3A4.
Roby 2000
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Topical application of St John's wort (Hypericum perforatum L.) and of its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells.
Schempp 2000
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While results do not provide evidence for a severe phototoxic potential of Hypericum oil and Hypericum ointment, detectable by the clinically relevant visual erythema score, there may be cause for concern in people with fair or diseased skin.
Schempp 2000
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HAM-D decreased from 16-24 to 11.5 on Hypericum (Ze 117) or 12.2 on fluoxetine (SSRI) in a 6 week, double-blind trial with 240 patients. Hypericum safety was substantially superior with adverse events being only 8% vs. 23%
Schrader 2000
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Modern antidepressants are no better than Hypericum of plant origin; meaning that safety, tolerability & acceptability of a medicine must be given much greater weight than its pharmacodynamics of simply testing against a placebo
Schulz 2000
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PMS symptoms (diary and psychological tests) of depression, anxiety, etc were reduced in a study with 19 women taking 300 mg/d St John's Wort for 2 months
Stevinson 2000
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H. perforatum showed 51% improvement in overall premenstrual syndrome scores with over two-thirds of the sample demonstrating at least a 50% decrease in symptom severity.
Stevinson 2000
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Significant improvement of obsessive-compulsive disorder with a drop in Yale-Brown Obsessive Compulsive Scale score and most common side effects being diarrhea and restless sleep.
Taylor 2000
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22% of presurgical patients reported the use of herbal remedies; especially echinacea, gingko biloba, St. John's wort, garlic & ginseng
Tsen 2000
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Mean HAM-D reduction of all St. John's wort studies was 10.2 (52.9%), and for fluoxetine was 12.5 points (55.5%) in a review of controlled trials
Volz 2000
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St John's wort may be a useful alternative to benzodiazepines to avoid nontreatment of early depression. Better tolerability than tricyclic antidepressants suggests benefit for elderly people. A review
Vorbach 2000
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Evaluation of 315 clinical trials shows Hypericum was more effective than placebo for mild to moderate depression (risk ratio 1.9) but publication bias might inflate the benefit
Williams 2000
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H. perforatum extract is therapeutically equivalent to imipramine in treating mild to moderate depression, but patients tolerate hypericum better.
Woelk 2000
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Review finds safety and effectiveness with Hypericum for depression, Kava for anxiety and Valerian, catnip, chamomile, gotu kola, hops, lavender, passionflower, skullcap for sleep
Cauffield 1999
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Evidence of herbs for the elderly includes Hypericum for depression, Ginkgo to delay dementia, Aesculus for venous insufficiency, Serenoa for BPH, Yohimbe for erectile dysfunction but still equivocal about Valerian for insomnia
Ernst 1999
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"Is the antidepressant effect of Hypericum extracts depending on their hyperforin content? " (no abstract)
Firenzuoli 1999
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Menopause psychological & psychosomatic symptoms diminished in 76% of participants by 900 mg/d Hypericum for 12 weeks in a trial with 111 women aged 43-65
Grube 1999
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HAMILTON global score fell from 16.6 to 7.9 with 800 mg of St. John's wort or from 17.2 to 8.11 with 20 mg fluoxetine in a study with 149 outpatients
Harrer 1999
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800 mg/d St. John's wort (LoHyp-57) was equivalent to 20 mg/d fluoxetine (CAS 54910-89-3) in a 6 week trial with 149 elderly patients with mild or moderate depression, with HAMD decreasing from 14 to 6 and 15 to 7, respectively
Harrer 1999
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von Zerssen depression score improved in 75% from 19.8-21.2 to 8.1-9.3 at week 6 for 647 mild to moderate depression patients taking hypericum extract LI 160 (Jarsin 300), 1 tablet t.i.d. Adverse events in 17% were mainly gastrointestinal (10%)
Holsboer-Trachsler 1999
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Review of clinical trials indicates Hypericum is as effective as other antidepressants and more effective than placebo and side effects are less than current U.S.-approved antidepressants
Josey 1999
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Review of 20 studies with 1,787 patients finds 600-900 mg is the effective dose and side effects are substantially fewer than with synthetic antidepressants. Photosensitization lacks clinical relevance at normal dosage
Kasper 1999
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Meta-analysis utilizing only well-defined clinical trials found Hypericum was 1.5 times more likely to get an antidepressant response than placebo and was as effective as tricyclic antidepressants with only half the side effects
Kim 1999
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"Hypericum special extract. Effectiveness in the elderly and in chronic disease " (German, no abstract)
Lemmer 1999
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Hamilton depression score was reduced to half in 2/3 of 348 mild to moderate depression patients taking hypericin @ 0.17, 0.33 or 1 mg/d for 6 weeks. Mild adverse reaction were seen in 7 (2%)
Lenoir 1999
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Inhibiting reuptake of all 3 major monoamines - 5-HT, noradrenaline & dopamine makes Hypericum the only antidepressant affecting all 3 with similar potencies. Better long-term studies are needed
Nathan 1999
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"New discoveries on St John's wort can improve pharmacotherapy in depression " (Swedish, no abstract)
Nordfors 1999
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Hamilton depression scores declined more with Hypericum extract (1050 mg/d) than imipramine (100 mg/d). Comparable results for Hamilton anxiety & clinical global impressions scales; in 8 week trial with 263 moderately depressed patients
Philipp 1999
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"Special dialogue: Herbal remedies for depression " (no abstract)
Stanga 1999
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More clinical studies since the Linde meta analysis (1996) provide further evidence that hypericum is superior to placebo in treating mild or moderate depression but comparison with modern antidepressants is insufficient
Stevinson 1999
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Limitations on available clinical trials should temper our enthusiasm and argue for more research before accepting Hypericum extracts into our pharmacopoeia; a critical review and proposal for further research
Vitiello 1999
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Seasonal affective disorder benefited after 8 weeks treatment with Hypericum (Kira) alone with a decline from 21.3 to 13 (n=168) or Hypericum plus light with a decline from 20.6 to 11.8 (n=133)
Wheatley 1999
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SJW is a safe antidepressant with an apparently unique mode of action . It demonstrated efficacy in mild and moderate depression when compared with placebo or tricyclic antidepressants and needs to be compared with serotonin reuptake inhibitors
Cott 1998
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High placebo response in Hypericum trials suggests mild transient depressions in participants so extrapolation to more serious or chronic depressions is unwarranted
Deltito 1998
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Depression is one of the most common reasons for using complementary and alternative therapies but, except for exercise, Hypericum & acupuncture, the amount of rigorous scientific data to support the efficacy is extremely limited
Ernst 1998
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Growing interest has led to a large randomized multicenter clinical trial of St. John's wort sponsored by NIMH
Eskinazi 1998
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Review of therapeutic efficacy, mechanisms of actions, dosages and regimens, preparations, and adverse effects for melatonin, St John's wort, valerian, and kava-kava
Heiligenstein 1998
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Review indicates 60-70% effectiveness for depression. It is well tolerated and adverse reactions are rare & mild (gastrointestinal, dizziness). If 900 mg/d does not help in 4-6 weeks other treatments should be tried
Hippius 1998
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Hyperforin decreased Hamilton scale by 10.3 (45 mg/d), 8.5 (4.5 mg/d), 7.9 (placebo) in a 6 week, randomized, double-blind, trial with 147 outpatients suffering from mild or moderate depression
Laakmann 1998
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Review indicates benefit for depression, seasonal affective disorder and in vitro antiviral activity. Traditionally used for wound healing, anti-inflammatory and analgesic activity
Miller 1998
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Review finds 14 trials with Hypericum showing it is more effective than placebo for mild to moderate depression (risk ratio 1.9) but insufficient data comparing with standard antidepressants
Mulrow 1998
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900 or 1800 mg, in a placebo controlled trial with healthy people, increased the latency to rapid eye movement (REM) sleep without producing any other effect on sleep, which is consistent with antidepressant activity
Sharpley 1998
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Review indicates good evidence for the efficacy of St John's wort for depression and for ginkgo in the treatment of memory impairment caused by dementia
Wong 1998
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"St. John's wort study launched " (no abstract)
anon 1997
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After six-weeks treatment, increase in ECG first degree AV-blocks and abnormalities of repolarization for imipramine but a significant reduction for Hypericum in double blind study with 209 depression patients taking up to 1800 mg
Czekalla 1997
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900 mg of hypericum for 4 weeks had reduced Hamilton Depression Rating Scale for seasonal affective disorder (SAD) patients. No added benefit was seen when bright light therapy was combined
Kasper 1997
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Review of 25 controlled clinical trials shows improvement in 61% of patients on low-dose treatment (<1.2 mg hypericum extract) & 75% on a higher dose (2.7 mg). Side effects were mild and occurred at lower frequency than with other antidepressants
Nordfors 1997
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Review of 12 placebo controlled trials with hypericum extracts shows mostly positive results
Volz 1997
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6-week trial comparing 1800 mg extract LI 160 to 150 mg imipramine in severely depressed patients found similar reduction in the Hamilton Depression Scale
Vorbach 1997
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6-week trial comparing 900 mg extract LI 160 to 75 mg amitriptyline in moderately depressed patients found similar reduction in the Hamilton Depression Scale. Adverse events with LI 160 in 37% vs. 64% in the amitriptyline group
Wheatley 1997
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Pharmacokinetics of hypericin: 250, 750, & 1,500 micrograms orally to 13 healthy adults causes dose dependent rise in plasma to 1.3, 7.2, & 16.6 micrograms/liter with a halflife of 2 days
Kerb 1996
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Meta-analysis of 23 trials with 1757 depressed patients shows Hypericum is about as effective as standard antidepressive treatment with far fewer side effects. More dropped out for placebo side effects than hypericum side effects
Linde 1996
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Review of psychotropic applications of Ginkgo biloba, Hypericum perforatum, Valerian officinalis, and Panex ginseng
Cott 1995
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Review of usage as antidepressive therapy
Ernst 1995
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70% response rate (similar to chemical antidepressants) in a placebo-controlled, double-blind trial with 97 depression outpatients treated with 100 - 120 mg of hypericum extract bid
Witte 1995
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Hypericum extract LI 160 was better than placebo in a 4 week study with 72 depressed patients. Hamilton depression score (HAMD) decreased more (21.8 to 9.2) than placebo (18.8 to 17.9) and response rate was 81% vs. 26%
Hansgen 1994
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900 mg hypericum extract gave similar benefit and less side effects compared with 75 mg maprotiline in a study with 102 depressed patients
Harrer 1994
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Meta-analysis of 25 controlled studies (15 with placebo) including 1592 depressed patients reveals dose was typically 300 - 900 mg/day of extract and duration 2 - 6 weeks
Harrer 1994
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900 mg hypericum extract LI 160 was better than placebo in a 4 week study with 39 depressed patients
Hubner 1994
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Randomized double-blind comparison of hypericum extract with maprotiline in 24 healthy volunteers showed similarity in EEG and improved cognitive functions mainly with hypericum
Johnson 1994
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900 mg/day of LI 160 to 12 healthy older volunteers for 4 weeks showed increased deep sleep during the total sleeping period without hypostatic influence of the REM sleep phases (which is typical for tricyclic antidepressants and MAOI)
Schulz 1994
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Hamilton Depression Scale fell from 15.8 to 7.2 by 900 mg/d hypericum extract for 4 weeks or to 11.3 in placebo group in a trial with 105 mildly depressed patients
Sommer 1994
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Pharmacokinetics: 250, 750, or 1500 micrograms hypericin or 526, 1578, or 3156 micrograms pseudohypericin) to 12 healthy men results in plasma levels1.5, 4.1, 14.2 ng/mL for hypericin or 2.7, 11.7, 30.6 ng/mL for pseudohypericin; halflife 1 - 2 days
Staffeldt 1994
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900 mg hypericum extract gave similar benefit and less side effects (fatigue 5%, restlessness 6%) compared with 75 mg imipramine in a study with 135 depressed patients
Vorbach 1994
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A trial with 3250 patients (49% moderate, 46% intermediate) showed 30% improvement in 4-weeks of extract LI 160. 2.4% had undesirable effects: GI upset (0.6%), fatigue (0.4%), restlessness (0.3%)
Woelk 1994
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LI 160 benefited 66.6% of depression outpatients compared with 26.7% in the placebo placebo group
Schmidt 1993
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The Cochrane Library contains evidenced based systematic reviews prepared by the Cochrane Collaboration.
Cochrane Library
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Observational Studies/Case Reports
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Associations of various herbal/specialty supplements including St. John's Wort with lung and colorectal cancer risk was examined.
Satia 2009
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An efficient and affordable photodynamic antimicrobial chemotherapy protocols which consists of local injection of mixtures of phenothiazines and Hypericum perforatum extract, to treat osteomyelitis in the feet of diabetic patients was described.
Tardivo 2009
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The case of a patient under tibolone therapy for two years who developed a mixed-type liver injury with prolonged cholestasis and features of the vanishing bile duct syndrome following a ten weeks treatment with St. John wort (Hypericum Perforatum) infusions is reported.
Etogo-Asse 2008
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An observational study in community pharmacies involving 588 individuals showed that patients who buy St. John's wort for self medication report pronounced and persistent depressive symptoms.
Linden 2008
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[Serotonin syndrome and rhabdomyolysis induced by concomitant use of triptans, fluoxetine and hypericum.]
Bonetto 2007
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A case of severe unilateral epistaxis requiring surgical arrest of bleeding, via endoscopic sphenopalatine artery ligation and anterior ethmoidal artery ligation was reported which followed recreational nasal insertion of St John's wort (Hypericum perforatum).
Crampsey 2007
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Comparison of differential effects of three species of Hypericum in an open field test shows 10 mg/kg of H. perforatum, a dose that is comparable to that endowed with antidepressant effects in humans, tended to increase exploration and stereotypic activity and to decrease immobility.
Diana 2007
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[Persistent fever due to ingestion of Hypericum perforatum (St. Johns wort)] [Article in Spanish]
Giner 2007
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Prolonged oro-facial dystonia in a 58 year old female following therapy with bupropion and St John's Wort.
Milton 2007
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Review on herbal and dietary supplements for treatment of anxiety disorders indicates that physicians should not encourage the use of St. John's wort, valerian, Sympathyl, or passionflower for the treatment of anxiety based on small or inconsistent effects in small studies.
Saeed 2007
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The prevalence and perceived benefit of complementary and alternative medicine (CAM) use for perceived body-shape changes among a cohort of HIV-positive patients was investigated and several subjects reported using ginseng, St John's wort, etc.
Cho 2006
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There is very weak scientific evidence based on a case report that St Johns wort is of minimal risk when taken during pregnancy.
Dugoua 2006
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St. John's wort was prescribed 40 times in a 1-year prevalence study of 68,403 nursing home residents living in 557 nursing facilities throughout the United States.
Harms 2006
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The fixed combination of black cohosh and St. John's wort extract is found to be superior to placebo in 301 women alleviating climacteric complaints, including the related psychological component.
Uebelhack 2006
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It has been found that St John's wort extract has the potential to lower the erythemal threshold to UVA1 irradiation in a significant proportion of individuals.
Beattie 2005
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It is shown that short term administration of St John's wort extract significantly induce cytochrome P-450 3A4, it does not alter the concentrations of most circulating androgens in men and women but may produce a diminution in some of the circulating 5alpha-reduced androgens.
Donovan 2005
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12 elderly subjects between the ages of 60 and 76 years, like their younger counterparts, are susceptible to herb-mediated changes in CYP activity, especially those involving St John's wort.
Gurley 2005
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Ephedra was associated with 7 of the 13 possibly related cases, and caffeine was contained in 5 of these supplement products. Creatine, St. John's wort, and ginkgo biloba were other DS implicated in possibly related seizure events.
Haller 2005
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A systematic review on large-scale observational studies of hypericum extracts in the treatment of depressive disorders reveals that hypericum extracts are well tolerated and seem to be effective in routine treatment of mild to moderate depressive disorders.
Linde 2005
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Long-term users of certain supplements like garlic, ginkgo, ginseng, melatonin, soy, and St. John's wort (Hypericum perforatum) experienced less weight gain than individuals who did not use the supplements.
Nachtigal 2005
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A 51-year-old woman had been having frightening suicidal and homicidal thoughts as a result of taking vitamin C and a herbal extract of St. John's wort. [Article in Dutch]
Nanayakkara 2005
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It is shown that the combination of hypericin and UVA light increased the genotoxic burden, and the risk of significant photogenotoxic damage incurred by the combination of Hypericum extracts and UVA phototherapy may be low in the majority of individuals.
Traynor 2005
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Review on antidepressants and pregnancy reveals that there exists no reservation against the use of St. John's wort during pregnancy and breastfeeding. [Article in German]
Tschudin 2005
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Review on increasing trends in elderly persons' use of nonvitamin, nonmineral dietary supplements and concurrent use of medications reveals that for women, there was a significant linear trend over time for these 12 supplements including St John's wort.
Wold 2005
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Review on the safety and efficacy of herbal sedatives in cancer care reveals that milder sedatives or anxiolytics in need of clinical study include German chamomile, lavender, hops, lemon balm, and passionflower; St. John's wort may have anxiolytic effects with relevance to sleep.
Block 2004
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Review on the use of antidepressant drugs in transplant recipients includes a brief discussion of St. John's wort and its impact on posttransplant drug therapy.
Kim 2004
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Three case studies aimed at discovering the molecular targets responsible for Hypericum perforatum, Salvia divinorum, and Ephedra sinica actions are presented.
Roth 2004
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Because of insufficient or conflicting evidence regarding the efficacy of conjugated linoleic acid, ginseng, psyllium, St. John's wort, etc. in weight loss, physicians should caution patients about the use of these supplements.
Saper 2004
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[First-episode psychosis after taking an extract of Hypericum perforatum (St John's Wort).]
Shimizu 2004
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Seventeen case reports associated the use of St. John's Wort with psychotic events was reported and in 12 instances, the diagnosis was mania or hypomania.
Stevinson 2004
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The Hypericum extract was found to be devoid of effects of sedation, anticholinergic reactions, gastrointestinal disturbances and sexual dysfunction often found in patients treated with tricyclic antidepressants or selective serotonin reuptake inhibitors.
Trautmann-Sponsel 2004
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In addition to a psychotherapeutic intervention or psychodynamic treatment or behavioral treatment, the first positive results of a psychopharmacological treatment regimen with opipramol and the St. John's Wort extract LI 160 has been reported. [Article in German]
Volz 2004
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An 80-yrs old man, previously on long-term digoxin treatment, started consuming St John's wort(SJW) herbal tea(HT)(2,000 ml/daily) because of frequent episodes of depression. After cessation of consuming HT containing SJW, digoxin poisoning developed in our patient.[Article in Serbian]
Andelic 2003
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A 23-year-old patient who had been taking St John's wort for postpartum depression for about 2 years was not recommended to use St John's wort during her pregnancy.
Goldman 2003
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A case with premenstrual dysphoric disorder (PMDD) previously treated with selective serotonin reuptake inhibitors, was substituted with St. John's wort and much improvement in PMDD symptoms was noted for at least five-month follow-up.
Huang 2003
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[St. John's wort in generalized anxiety disorder: three more case reports.]
Kobak 2003
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Among 500 peri- and postmenopausal women outpatients between the ages of 40 and 60 years at the University of Illinois at Chicago clinics, botanical dietary supplements were used by 79% of respondents and St. John's wort were used by 7.34%.
Mahady 2003
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[Hypertension induced by St. John's Wort - a case report.]
Zullino 2003
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[Depression: St. John's wort is only effective after 2 to 3 weeks. Initial phase can be bridged with baldrian] [Article in German]
[No authors listed] 2002
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[Review: St. John's wort, ginkgo, saw palmetto, and kava may be effective for some conditions.]
Baime 2002
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High-dose treatment with Saint John's wort extract induced CYP3A activity in healthy volunteers was evidenced by increased 6beta-hydroxycortisol excretion.
Bauer 2002
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[Delayed emergence and St. John's wort.]
Crowe 2002
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Reported case of mania induced by high doses of Hypericum perforatum in depressed woman with no past history of mania or hypomania and no concomitant use of antidepressants.
Fahmi 2002
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Comparisons of presupplementation & postsupplementation ratios indicated that St John's wort induced activity of CYP2E1 and CYP3A4 (P <.0001). Among female subjects, St John's wort produced greater increases in CYP3A4 phenotypic ratios that appeared to be unrelated to body mass index.
Gurley 2002
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Review on the peri-operative implications of herbal medicines indicates that an increasing number of patients are taking herbal medicines such as echinacea, garlic, ginkgo biloba, ginseng, St John's Wort, valerian, ephedra, kava, grapefruit juice and ginger.
Hodges 2002
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Hyperforin is excreted into breast milk at a low level, hypericin is not. Both hyperforin and hypericin were below the lower limit of quantification in infant plasma.
Klier 2002
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Evidence for alternative treatments for depression, anxiety, and insomnia are reviewed and treatment of depression with St. John's wort, L-tryptophan, 5-hydroxytryptophan, S-adenosylmethionine, dehydroepiandosterone, folate, exercise, acupuncture, and meditation are examined.
Larzelere 2002
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Hypericum perforatum extract WS 5570 was found to be safe and more effective than placebo for the treatment of mild to moderate depression in male and female adult outpatients.
Lecrubier 2002
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[St. John's Wort: more implications for cancer patients.]
Mansky 2002
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It is shown that experienced physicians achieve virtually the same treatment results with suitable St. John's wort preparations as they do with modern synthetic antidepressants. [Article in German]
Schulz 2002
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Review on gynecology shows that some evidence points to the efficacy of black cohosh, exercise, and possibly Kava and St. John's wort, in the treatment of menopausal symptoms.
Sidani 2002
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Case of female patient with history of mild traumatic brain injury and resulting depression experiencing hypomania after adding SJW and Ginkgo biloba to her regimen of fluoxetine and buspirone.
Spinella 2002
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[St John's wort was not better than placebo for reducing symptoms in major depressive disorder.]
Swann 2002
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Comparision of the change in severity of depressive symptoms and occurrence of side effects in primary care patients treated with St John's wort (SJW) and sertraline shows that the more benign side effects of SJW make it a good first choice for this patient population.
van Gurp 2002
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Drop in plasma cyclosporine was attributed to treatment with St John's wort.
Beer 2001
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[Effectiveness of St. John's Wort in major depression apparently not indicated] [Article in German]
Berner 2001
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A patient taking SJW developed a severe phototoxic reaction to laser light at 532 nm and also an exaggerated and unexpectedly severe response to pulsed dye laser light at 585 nm.
Cotterill 2001
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[St. John's wort in generalized anxiety disorder: three case reports.]
Davidson 2001
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A probable association between St. John's wort and elevated thyroid-stimulating hormone levels have been evaluated in 37 subjects.
Ferko 2001
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[Is St John's wort a 'Prozac-like' herbal antidepressant?]
Gobbi 2001
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Review on herbal medicines today and the roots of modern pharmacology indicates that many herbs have been evaluated in randomized, controlled trials, and several-St. John's wort and ginkgo, for example-are apparently effective.
Goldman 2001
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23-year-old woman with no psychiatric history developed acute mania and psychosis while using a combination of valerian extract and hypericin.
Guzelcan 2001
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Review on herbs and alternative therapies in the hypertension clinic reveals that herbals including ma huang, St. John's wort, yohimbine, garlic, and licorice all may cause important consequences in the hypertensive patient.
Mansoor 2001
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[Vitamin C causes cancer! St. John's wort useless for depression!]
Miller 2001
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[General practice research study of St. Johns Wort extract WS 5572. Normally 600 mg per day is enough] [Article in German]
Rychlik 2001
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Review on herbal medicines and epilepsy indicates that St. John's wort has the potential to alter medication pharmacokinetics and the seizure threshold.
Spinella 2001
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"St. John's Wort and HAART " (no abstract)
anon 2000
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SJW supplements caused subtherapeutic cyclosporine concentrations in a 29-year-old kidney and pancreas transplants recipient.
Barone 2000
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Evidence based psychiatry & clinical examples
Berner 2000
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Development of severe acute rejection 14 months after liver transplantation in 63-year-old patient was attributed to interaction between cyclosporin A and H. perforatum.
Karliova 2000
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Re-calculating the sample size in internal pilot study designs with control of the type I error rate; Hypericum example
Kieser 2000
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A kidney transplantation patient showed temporal relationship to hypericum extract comedication experienced as a sudden drop in her cyclosporin trough concentrations.
Mai 2000
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"Experience with the treatment of depressive patients wtih deprim " (Russian, no abstract)
Tochilov 2000
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Review of evidence for echinacea, garlic, ginger, ginkgo, St John's wort, and valerian
Barrett 1999
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"A depressed man requesting St John's wort " (case report, review, no abstract)
Ernst 1999
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Alternative therapies for advanced prostate cancer may include St John's Wort
Moyad 1999
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St John's Wort may have use for depression associated with cancer
Moyad 1999
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Interviews with 22 SJW users noted trend of belief in the need for personal control of health and self-diagnosis of "minor" depressed mood
Wagner 1999
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Three of 4 adolescents who used Hypericum while under psychiatric care were reluctant to reveal this, believing the doctor would disapprove. Clinicians are advised to routinely ask about alternative medicine use
Walter 1999
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Three nervines which have attracted considerable attention recently are St John's Wort, Gingko biloba and Valeriana officinalis. The extent of use for mental illness suggests that psychiatrists should become more knowledgeable about them
Walter 1999
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Selective tumor-targeting by topical intralesional hypericin, 40-200 microgm, 3-5 times per week for a few weeks, for 19 patients (8 squamous cell & 11 basal cell). No necrosis was seen and new epithelium formed at the surface of the malignancy
Alecu 1998
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"St John's wort during pregnancy" (no abstract)
Grush 1998
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"St. John's wort: an alternative therapy in treating depression " (no abstract)
Kupecz 1998
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""Goodbye to the life I used to live" St. John's wort " (no abstract)
Mack 1998
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"Can an herb really help depression?" (no abstract, review)
Myers 1998
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There is good evidence for the efficacy of St John's wort for the treatment of depression
Wong 1998
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St John's wort shows promise as a treatment for depression so physicians should educate themselves and their patients about the efficacy and adverse interactions
Zink 1998
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"St. John's wort: an herbal remedy for depression? " (no abstract)
Evans 1997
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Hypericin (polycyclic quinone) as a photosensitizer (632 nm activation) for a case of malignant mesothelioma
Koren 1996
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A glioma that was treated with and developed resistance to radiation and tamoxifen was still sensitive to hypericin
Zhang 1996
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The use of unconventional remedies among 63 HIV-positive men in California
Dwyer 1995
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Staphylococci, shigellae & E. coli treatment with extract from oak cork, St. John's wort leaves & flowers and pine buds which may be useful for otorhinolaryngological diseases, enterocolitis in children and bacterial eczema
Kolesnikova 1986
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Chronic colitis pains along the large intestine disappeared in 96% of 24 patients by the 15th day with a combination of Taraxacum, Hypericum, Melissa, Calendula officinalis and Foeniculum
Chakurski 1981
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"Use of St.-John's-wort for the x-ray study of the large intestine " (Russian, no abstract)
Omarov 1979
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"Treatment of suppurative infection with St. John's-wort and kalanchoe preparations " (Russian, no abstract)
Kiriliuk 1977
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"Photodynamic action of extractum hyperici in the treatment of vitiligo" (no abstract, Polish)
Nowak 1974
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Traditional and Folk Use
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Meta-analysis concludes that Hypericum products are effective in the treatment of mild to moderate depression with fewer side effects compared to traditional antidepressants. [Article in Hebrew]
Baruch 2009
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Select complementary and alternative treatments in pediatric bipolar disorder and/or depression, includes omega-3-fatty acids, inositol, St. John's wort, SAMe, melatonin, lecithin, and acupuncture.
Potter 2009
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The authors review research on the possible benefits and risks of commonly used herbal medications such as arnica montana, St. John's wort, bromelain, echinacea, ginkgo biloba, ephedra, valerian, and others.
Rowe 2009
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Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.
Sarris 2009
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The compounds in St. John's wort herbal preparations are more effective than placebo and, in several studies, more effective than common antidepressant medications in treating minor depression.
Carpenter 2008
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A bibliometric study on scientific publication related to phytotherapy in the psychiatry area during the period 1986-2006 shows the plants most widely mentioned in the psychiatric literature were St. John's wort and ginkgo.
Garc?Garc?2008
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The effects of an extract of Hypericum perforatum L. on substance dependence and its possible benefit have been discussed in the light of current literature.
Uzbay 2008
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With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression.
van der Watt 2008
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[Complementary, holistic, and integrative medicine: St. John's wort.]
Charrois 2007
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Among 83 wild species which are most commonly used for medicinal purposes, Hypericum perforatum, Urtica dioica, Achillea millefolium, Matricaria chamomilla, Sambucus nigra & Thymus serpyllum were particularly highly recommended by majority of informants as being 'beneficial for all ailments'.
Jari?007
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126 traditional medicinal plants including Hypericum perforatum from Kirklareli Province in Turkey have been mostly used for the treatment of wounds (25.3%), cold and influenza (24.6%), stomach (20%), cough (19%), kidney ailments (18.2%), diabetes (13.4%).
K?2007
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Wounds and injuries are treated with 14 plants including Achillea millefolium, Capsella bursa-pastoris, Hypericum perforatum, Lavandula officinalis, Symphytum officinale and Curcuma longa.
Lans 2007
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The general practitioner?s knowledge and recommendation of St. John's Wort for mild to moderate depression within a climate of widespread community use of complementary therapies and debate about regulation was determined.
McGarry 2007
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Natural medications such as St. John's Wort, SAMe, and omega-3 fatty acids eventually may prove to be valuable additions to the psychiatrist's pharmacologic armamentarium, both as monotherapy and as adjunctive therapy for mood disorders.
Mischoulon 2007
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[St. John's wort extract in treatment of moderately severe depression] [Article in German]
Willich 2007
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St John's Wort products, which are approved for antidepressant use by the German drug agency, and tricyclic antidepressants (TCAs), accounted for more than 80% of antidepressant use in children and adolescents in Germany.
Fegert 2006
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Reviews on the literature for alternatives to plant estrogens for menopausal symptoms indicates that St. John's wort can improve mood disorders related to the menopausal transition.
Geller 2006
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The most important medicinal plants, including Ginkgo biloba, St John's wort, Kava-kava, Valerian, Bacopa monniera and Convolvulus pluricaulis, which are widely used for their reputed effectiveness in CNS disorders have been reviewed.
Kumar 2006
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Herbs with safety issues, such as St John's wort, dong quai, and kava were used by Kansas and Wisconsin women, infants, and children participants.
Lohse 2006
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The development of the evidence on the herbal remedy, St John's wort (Hypericum perforatum), in the treatment of depression was reviewed.
Pilkington 2006
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Review on complementary and alternative therapies for climacteric symptoms shows that St. John's wort is an option for the treatment of moderate depressive symptoms. [Article in German]
Reinhard-Hennch 2006
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Review on the evidence of efficacy of different types of Complementary and Alternative Medicine in depression indicates Grade 1 evidence on the use of St. John's wort, Tryptophan/5-Hydroxytryptophan, S-adenosyl methionine, Folate, Inositol, etc.
Thachil 2006
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The potentially useful complementary medicines used in psychiatry include ginkgo and hydergine as cognitive enhancers, passion flower and valerian as sedatives, St John's wort and s-adenosylmethionine as antidepressants, and selenium and folate to complement antidepressants.
Werneke 2006
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[St. John's wort in depression. The question is not whether it is effective but how do we use it.] [Article in German]
Anghelescu 2005
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Effective psychoactive agents to self-treat many common psychiatric problems include 'medical' psycho-pharmacological agents such as analgesics and antihistamines, a plant extract called St. John's Wort (Hypericum), & physical treatments such as early morning bright light therapy.
Charlton 2005
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St. John's wort has been shown to improve mild to moderate depression in the general population and appears to show efficacy for mood disorders related to the menopausal transition.
Geller 2005
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Review on trends in ethnopharmocology shows that Ispaghula, Garlic, Ginseng, Ginger, Ginkgo, St. John's Wort, and Saw palmetto are a few examples of botanicals which are gaining popularity amongst modern physicians.
Gilani 2005
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Soy, St. John's Wort, Silybum marianum, Ginkgo biloba, Citrus species, Vaccinum mirtillus, Hawthorn and tea are medicinal plants containing flavonoids whose efficacy in the treatment of a variety of diseases has been demonstrated in numerous clinical studies. [Article in Italian]
Firenzuoli 2004
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Use of a syrup prepared from wild-growing grasses of the Far East including dog rose, herbs St. John's wort, parsley, Nettle and Laminal were studied in preventive maintenance of respiratory diseases and microelementoza at children. [Article in Russian]
Kosolapov 2004
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The chemical diversity of spontaneous populations is one of the main directions of investigations on medicinal and aromatic plants and the target species under research includes Thymus spp., Hypericum spp., etc. [Article in Lithuanian]
Radusiene 2004
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[Review: St John's Wort may be less effective than previously thought in people with depression.]
Reddy 2004
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[Johanniskraut. Hypericum perforatum L.] [Article in German]
Tschupp 2004
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A review on herbal supplement use among US women revealed that bivariate & multivariate analyses conducted to examine relationship between sociodemographic, health status & behavior characteristics & use of 1) any herbal supplement 2) Echinacea, Ginkgo biloba, ginseng, or St. John's wort.
Yu 2004
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[From a 2500 year old apotropic comes a current antidepressive. The cultural history and mistique of St. John's wort] [Article in German]
Czygan 2003
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St. John's wort, an unregulated herbal supplement widely used as a self-treatment for depression, can cause side effects and drug interactions.
Deshmukh 2003
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[St. John's wort flowers and basis for use...] [Article in German]
Dingermann 2003
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The historical background, active ingredients of St. John's Wort and the major double-blind placebo-controlled studies have been reviewed which shows that hypericum extracts are more effective than placebo for the treatment of mild to moderate depressive illness.
Gupta 2003
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The certain & potential spectrum of internal & external uses of St. John's Wort includes gastro
intestinal complaint & illness,skin disease, mucosal lesion, depressive upset & depression, restlessness, nervosity, convalescence, exhaustion, sleep disturbance & nursing treatment.[Article in German]
Saller 2003
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A study was undertaken to investigate 500 registered nurses' knowledge about and use of five common herbal products such as ginkgo, St. John's wort, ginseng, garlic, and echinacea.
Sand-Jecklin 2003
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Review on herbs commonly used by women reveals that St John's Wort is efficacious for treating mild to moderate depression but has many drug interactions.
Tesch 2003
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It is proved that Hypericum is beneficial for the treatment of mild-to-moderate depression, with a very favorable side effect profile.
Verotta 2003
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Review on the use of alternative medicine in the treatment of hepatitis C indicates that some patients with hepatitis C take St. John's Wort and ginger to treat the side effects caused by interferon therapy.
Bean 2002
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Review on the effectiveness of complementary and self-help treatments for depression indicates that the treatments with the best evidence of effectiveness are St John's wort, exercise, bibliotherapy involving cognitive behaviour therapy and light therapy (for winter depression).
Jorm 2002
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The paper reviews current scientific data on the most important herbal substances including St. John's wort, kava, valerian, and gingko. [Article in German]
Kalus 2002
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The efficacy of selected alternative treatments for unipolar depression including exercise, stress management techniques, acupuncture, St. John's wort, bright light, and sleep deprivation was reviewed.
Manber 2002
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The efficacy and safety of Ginkgo biloba, St. John's wort, ginseng, Echinacea, saw palmetto and kava have been overviewed based on American experiences. [Article in Swedish]
Mattsson 2002
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Review on alternative therapies for traditional disease states of menopause shows that the evidence for St. John's wort is equivocal.
Morelli 2002
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St. John's wort is used in several therapeutic fields like neuropsychiatry, dermatology and in rheumatology. In herbal remedies and homeopathy, the flower heads are often prescribed as antidepressor in the treatment of mild to moderate depression. [Article in French]
Neuman 2002
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[St John's wort as treatment for depression.]
Oppel 2002
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Women and patients aged 40-60 yr were most likely to be taking a herbal product (P<0.05 and P<0.001 respectively). The most commonly used compounds were, in descending order, garlic, ginseng, ginkgo, St John's wort and echinacea.
Skinner 2002
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An evidence-based review on herbs commonly used by women indicates that St John's Wort is efficacious for treating mild to moderate depression but has many drug interactions.
Tesch 2002
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[Pharmacy through the ages. Hypericum perforatum.]
Worthen 2002
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Data on the use of St. John's Wort, S-adenosyl-methionine, B vitamins, inositol, omega-3 fatty acids, & choline for mood disorders; data on the use of kava and other herbal agents & fish extract for anxiety and insomnia; and data on valerian and melatonin for insomnia were reviewed.
Brown 2001
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[St. Johns wort--the mystery of change] [Article in Norwegian]
Glad 2001
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In addition to antidepressant effect, new psychiatric uses for hypericum in obsessive-compulsive disorder, generalized anxiety disorder, menopausal symptoms, and alcohol dependence have been reported.
Meltzer-Brody 2001
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FTC reaches settlements on AIDS claims for St. John's Wort.]
Muris 2001
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The most frequently used nonvitamin, nonmineral dietary supplements products among college students were echinacea, ginseng, and St John's wort.
Newberry 2001
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Review on herbal medicine shows that drugs such as St John's wort, ginkgo, saw palmetto have sufficient clinical studies to consider orthodox use.
Pinn 2001
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Examination of the rate of utilization of complementary and alternative medicine (CAM) in Amish women, indicates that ten pregnant Amish women reported using echinacea, St. John's Wort, red clover, garlic and ginseng.
von Gruenigen 2001
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Survey of 43 SJW users indicates most take it for depression, 74% without medical advice. 36 report benefit; 20 report side effects. Mean dosage=475 mg/day (300-1200), mean duration=7.3 weeks (1 day -5 yr)
Beckman 2000
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The history of transitioning from being considered alternative to being orthodox remedies indicates that suggestions for greater regulation and licensing of herbal remedies will increase healthcare costs so should only be done selectively
Ashcroft 1999
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Of 20 toothbrush sticks from Ethiopia, only Agave sisalana, Birbira & Hypericum revolutum showed weak toxicity to brine shrimp while all were antibacterial against Staphylococcus aureus and Bacillus cereus
Kassu 1999
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"Hypericum perforatum L., St. John's wort, a medicinal plant in folk medicine " (German, no abstract)
Kopp 1999
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Review of nine nutrient and herbal remedies commonly used for diabetes
Mozersky 1999
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In 1996 131.5 million daily doses of preparations containing extracts of Hypericum perforatum L. were prescribed in Germany for treating mild to moderately severe depressive disorders
Orth 1999
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Of 21 Nepalese medicinal plants the methanol extracts from Hypericum, Lygodium & Maesa were effective in assays against 3 viruses
Taylor 1996
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"Han-lian-cao" a Taiwanese drug derived from Wedelia and Hypericum
Chen 1992
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Sarothralin G: a new antimicrobial compound from Hypericum japonicum, contains phloroglucinol and filicinic acid moieties. It is used traditionally for infectious hepatitis, bacterial diseases, gastrointestinal disorders, and tumors
Ishiguro 1990
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Folk use of mint, thyme, red juniper, Hypericum in northwestern Greece coincides with usage elsewhere in the Mediterranean region
Tammaro 1986
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Monograph in "A Modern Herbal" by Mrs. M. Grieve at
botanical.com
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Adverse Effects & Toxicity
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From 1420 interviews some (3.9%) referred to adverse effects like allergic reactions to shark cartilage, propolis and thyme; anxiety after hypericum; hypotension and tachycardia after a mix containing chamomile, valerian and melissa; pyrosis and stomach-ache after laxative-depurative herbs.
Cuzzolin 2009
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Clinically significant orthostatic hypotension occurs less commonly with selective serotonin reuptake inhibitors, and rarely with moclobemide and bupropion, and is not reported as a significant adverse effect of hypericum (St John's wort).
Darowski 2009
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Center for Food Safety and Applied Nutrition's Adverse Event Reporting System reports involving ginseng dietary botanical supplements were most frequently reported during the study period, whereas reports involving St. John's wort were the least frequently reported.
Wallace 2008
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[Hepatotoxicity associated with Hypericum (St. John's wort)] [Article in Spanish]
Dom?uez Jim?z 2007
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The reports to poison control centers involving two widely used herbal dietary supplements, Echinacea, and St. John's wort were characterized.
Gryzlak 2007
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Ingested St. John's wort by human retinal pigment epithelial cells is potentially phototoxic to the retina and could contribute to retinal or early macular degeneration.
Wielgus 2007
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Hyperforin, an acylphloroglucinol compound, isolated from Hypericum perforatum, may be useful to decrease amyloid burden and toxicity in Alzheimer's disease patients, and may be a putative therapeutic agent to fight the disease.
Dinamarca 2006
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Among the identification of 34 studies of variable methodologic quality on anti-depressive therapies after heart transplantation, St John's wort, an alternative herbal drug, has been associated with life-threatening immunosuppression.
Fusar-Poli 2006
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In a 48-year-old female patient, acute hepatitis with transaminase increase inconspicuous hepatitis serology findings, negative autoantibody status & negative virus serology was observed after a 10-week intake of kava-kava (1-3 x 200 mg/day) & St John's Wort (1 x 425 mg/day). [Article in German]
Musch 2006
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Hypericin combined with Hypericum perforatum extracts or constituents exert less phototoxicity than pure hypericin, possibly not through a reduction in arachidonic acid peroxidation.
Schmitt 2006
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All extracts of Hypericum perforatum exhibited significant cytotoxicity, those prepared in ethanol showed between 7.7 and 77.4% cell survival, whereas the chloroform and hexane extracts showed approximately 9.0 (p < 0.0001) and 4.0% (p < 0.0001) survival.
Schmitt 2006a
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The toxicity of Hypericum perforatum administered to female rats during organogenesis (9th to 15th day of pregnancy) was evaluated. H. perforatum does not seem to be toxic with 36 mg/Kg body weight of Jarsin dried extract administered in 0.5 ml of saline. [Article in Portuguese]
Borges 2005
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Hypericum perforatum does not seem to be toxic to mother Wistar rats or to interfere with the progress of gestation during organogenesis.
Borges 2005a
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A 22-year-old man who had taken 1000 mg/day of flowering herbs of Hypericum perforatum L, for treatment of depression had severe hematologic toxicity, with conditions involving bone marrow necrosis.
Demiroglu 2005
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Aerobic exercise, St. John's wort (SJW), and S-Adenosylmethionine have considerable empirical support in otherwise healthy persons, but SJW may have undesirable side effects for coronary heart disease patients.
Lett 2005
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The nature and mechanism of action of the phytochemicals presently receiving increased attention in the field of food toxicology was described which relates to 17 compounds including beta-carotene, coumarin, anisatin, St. John's wort ingredients.
Rietjens 2005
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[Review: hypericum extracts are safer and lead to fewer adverse effects than older standard antidepressants, but have similar tolerability to SSRIs.]
Valerio 2005
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It is shown that the complementary and alternative medicinal agents including angelica, German chamomile flower, ephedra, gingko, grape seed extract, licorice root, St. John's wort, kava kava rhizome, peppermint, stinging nettle, and ginseng, are also associated with significant adverse effects.
Bielory 2004
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The effects of a treatment with hypericum administered prenatally and during breastfeeding was investigated in Wistar rats which revealed a severe damage in the livers and kidneys of treated animals.
Gregoretti 2004
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Exposure of human lens epithelial cells to 0.1-10 microM hypericin and irradiation with 4 J/cm2 UV-A or 0.9 J/cm2 visible light shows that ingested St. John's Wort is potentially phototoxic to the eye and could contribute to early cataractogenesis.
He 2004
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Data from 35 double-blind trials showed that dropout & adverse effects in patients receiving hypericum extracts were similar to placebo, lower than with older antidepressants, & selective serotonin reuptake inhibitors suggesting that hypericum extracts are well tolerated & safe.
Knuppel 2004
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The literature on the potential risks of commonly used herbal medications of Ginkgo Biloba, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, Garlic, Kava and Ephedra was reviewed. [Article in Hebrew]
Zlotogorski Hurvitz 2004
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Some of the more noteworthy medicinal plants for which neurological toxicity has been reported are Hypericum perforatum, kava kava (Piper methysticum), Aconitum sp. and Callilepis laureola. [Article in Spanish]
Carod Artal 2003
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[Suspected withdrawal syndrome after cessation of St. John's wort.]
Dean 2003
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A brief description of pharmacodynamics and clinical applications, followed by a systematic review of adverse effects, toxicity, and drug interactions have been presented.
Hammerness 2003
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[Adverse drug effects and interactions. What is the current thinking about the use of St. John's wort?] [Article in German]
Johne 2003
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Some adverse side-effects connected with the plant, Saint-John's-wort includes photosensitivity, and the interactions with other drugs or foodstuffs. [Article in Slovak]
Kapusta 2003
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[Hypericum perforatum L. and Chamomilla recutita (L.) Rausch.--accumulators of some toxic metals.]
Kral'ova 2003
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Photosensitivity, an abnormal skin reaction to light, is a rare adverse event associated with herbal medicine use and case reports in the literature most commonly implicate St. John's wort.
Palanisamy 2003
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Some of the side effects of Hypericum perforatum extracts like nausea, rash, fatigue, restlessness, photosensitivity, acute neuropathy, and even episodes of mania and serotonergic syndrome when administered simultaneously with other antidepressant drugs have been reviewed.
Rodriguez-Landa 2003
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Current research findings suggest that St. John's wort may be an effective treatment for mild depression; however, evidence of significant adverse drug interactions with St. John's wort should not be overlooked.
Boehnlein 2002
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A case of mania induced by high doses of Hypericum perforatum in a 28-year-old depressed woman with no past history of mania or hypomania and no concomitant use of antidepressants was reported.
Fahmi 2002
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The herbs, identified on the basis of California Poison Control System-San Francisco division call frequency were: St John's wort, ma huang, echinacea, guarana, ginkgo, ginseng, valerian, tea tree oil, goldenseal, arnica, yohimbe and kava kava.
Haller 2002
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[Hypertensive crisis associated with St. John's Wort.]
Patel 2002
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Adverse reactions to Hypericum extract in the clinical treatment of depression include skin reddening and itching, dizziness, constipation, fatigue, anxiety, and tiredness.
[No authors listed] 2001
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A patient who developed a severe phototoxic reaction to laser light at 532 nm and also an exaggerated and unexpectedly severe response to pulsed dye laser light at 585 nm is described. It subsequently transpired that the patient was taking St John's Wort at the time of laser treatment.
Cotterill 2001
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A 23-year-old lady with no psychiatric history developed acute mania & psychosis while using St. John's wort at a high dosage (Valdispert 'balans', a combination of valerian extract & hypericin) & she was diagnosed as having substance-induced mood disorder, with mania. [Article in Dutch].
Guzelcan 2001
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St John's wort may cause serotonin syndrome in sensitive patients.
Parker 2001
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Review of incidence and clinical relevance of the interactions and side effects of Hypericum preparations.
Schulz 2001
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"Drug interactions with st. John's wort " (no abstract)
anon 2000
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Case of a patient who developed depression following bilateral orchidectomy for cryptorchidism, taking both SSRI & Hypericum who developed a manic episode where testosterone replacement might have been affected
Barbenel 2000
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"Acute St. John's wort toxicity " (case report, no abstract)
Brown 2000
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"Photosensitivity associated with herbal preparations of St John's wort " (letter, no abstract)
Lane-Brown 2000
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"From the Food and Drug Administration " (no abstract)
news 2000
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"Patients being treated for HIV should avoid St. John's Wort: NIH " (no abstract)
news item 2000
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"Drug interactions with Hypericum. Is nature not so mild after all? " (German, no abstract)
Roots 2000
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Minimal erythema dose of Hypericum oil (hypericin 110 microg/mL) or ointment (hypericin 30 microg/mL) on forearm of 16 people was unchanged by visual score but some increase seen with the more sensitive photometric measurement
Schempp 2000
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Adverse events for fluoxetine were 23%: agitation (8%), GI disturbances (6%), retching (4%), dizziness (4%), tiredness, anxiety/nervousness & erectile dysfunction (3% each); and 8% for Hypericum: GI disturbances (5%) in a clinical trial with 240 patients
Schrader 2000
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"Herbal supplements and prescription drugs. A risky combination? " (news, no abstract)
Stein 2000
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Bromodeoxyuridine incorporation into keratinocyte DNA was decreased by hypericin (>50 microgm/mL) with visible (2.6 mumol/m2s) or UVA (1 J/cm2), but not UVB (150 mJ/cm2) light. Absorbance spectrum of Hypericum extract has maxima in the whole UV range
Bernd 1999
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"St. John's Wort: is it effective and harmless? " (no abstract)
Biron 1999
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Common culprits of phytophotodermatitis are Umbelliferae, Rutaceae, and Moraceae and St John's Wort
Bowers 1999
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Review of phytophotodermatitis by common culprit plant families of Umbelliferae, Rutaceae, Moraceae & St. John's Wort; including the mechanism involved, clinical features, and treatment options
Bowers 1999
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"Second thoughts about safety of St John's wort" Case reports affecting blood levels for 1 patient on theophylline, 3 on cyclosporin, 1 on warfarin, 3 on ethinylestradiol/desogestrel raise the possibility of regulation (comments in Feb 12 Lancet)
Ernst 1999
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"Toxicity of Hypericum perforatum " (case report, no abstract)
Firenzuoli 1999
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Of 30 HIV patients who tried hypericin (0.25 or 0.5 mg/kg i.v. 2-3 times weekly, or 0.5 mg/kg/d orally) 16 discontinued early because of toxic effects. Severe cutaneous phototoxicity was seen in 11. Virologic markers did not significantly change
Gulick 1999
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Hypericin (40 mg/kg i.p.) with light (108 J/cm2) was lethal to mice. Erythema, desquamation & erosions resulted from hypericin-solketal ointment with light (> 4.5 J/cm2). There is potential for treating psoriasis
Kamuhabwa 1999
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Hypericin was only slightly photogenotoxic to V79 cells
Kersten 1999
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Photofrin II & mTHPC induced photosensitivity is reversed by hypericin in Staphylococcus aureus
Kubin 1999
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Two cases of mania temporally associated with the use of St. John's wort suggesting evaluation of its propensity to cause affective switching is needed
Nierenberg 1999
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Sperm motility was inhibited by high concentration (0.6 mg/mL) of St. John's wort. Also by saw-palmetto, echinacea & gikgo
Ondrizek 1999
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Pretreatment of oocytes with 0.6 mg/mL of St. John's wort resulted in zero sperm penetration and denatured DNA. A lower concentration (0.06 mg/mL) had no effect. Echinacea and Ginkgo were also imhibitory. Saw palmetto had no effect
Ondrizek 1999
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Intracutaneous application of 100 ng/ml hypericin gives no phototoxic reaction. Hypericin has Abs peaks of 330, 550 & 588 nm. PDT 1200 SOA (520-750 nm) is four (in vitro) or ten times (in vivo) more effective than a 1000 watt solar simulator (290-2500 nm)
Schempp 1999
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Ma huang, St. John's wort, and kava are examples of readily available psychotropic herbs with the potential for negative effects
Tinsley 1999
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"Acute neuropathy after exposure to sun in a patient treated with St John's Wort " (no abstract)
Bove 1998
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A case of stinging pain in the face & hands after taking 500 mg/d Hypericum for 4 weeks. Symptoms began to clear after 3 weeks and were gone in 2 months
Bove 1998
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"Beware "St. John's Wort," potential herbal danger " (no abstract)
Ciordia 1998
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A systematic review of adverse drug reactions of Hypericum found some gastrointestinal symptoms, dizziness/confusion and tiredness/sedation with an incidence similar to that of placebo. Photosensitivity is extremely rare
Ernst 1998
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Albumin extensively inhibits the photocytotoxic effect of pseudohypericin against A431 tumour cells
Vandenbogaerde 1998
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Case report of depression patient taking St. John's Wort-extract for three years having itching erythematous lesions in light-exposed areas
Golsch 1997
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A 4-week trial with 3250 patients showed 30% improved, 2.4% had undesirable effects: gastrointestinal irritations (0.6%), allergic reactions (0.5%), tiredness (0.4%), and restlessness (0.3%)
Woelk 1994
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Sheep experimentally poisoned with Hypericum perforatum had lower hemoglobin, RBC, glucose, cholesterol, alk. phosphotase and higher BUN, bilrubin, aminotransferase, etc
Kako 1993
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A case of St. John's wort photosensitization poisoning in sheep is given
Kumper 1989
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Interactions
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It has been indicated that St. John's Wort requires further study with regard to safety in pregnancy, and drug interactions can be a potential problem.
Freeman 2009
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[Reduced efficacy of rosuvastatin by St. John's Wort.]
Gordon 2009
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Case reports suggest interactions of St John's wort with adrenergic vasopressors, anaesthetics, buspirone, ciclosporin, loperamide, nefazodone, nevirapine, oral contraceptives, paroxetine, phenprocoumon,prednisone,sertraline, tacrolimus, theophylline, tryptophan, venlafaxine & warfarin.
Izzo 2009
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The most important risk associated with Hypericum extracts are interactions with other drugs. Therefore, physicians need to be informed whether their patients take St. John's wort products.
Linde 2009
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[Interaction between Saint Johns Wort and alcohol deterrents?] [Article in Swedish]
Schwan 2009
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A number of interactions of St. John's wort have been seen with many drugs, including anticancer agents (imatinib & irinotecan), anti-HIV agents (indinavir, lamivudine & nevirapine), anti-inflammatory agents (ibuprofen & fexofenadine), antimicrobial agents (erythromycin & voriconazole).
Di 2008
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The interaction mechanisms of St. John's Wort by pregnane X-receptor mediated upregulation of cytochrome-P450 enzyme 3A4 & p-glycoprotein expression & of grapefruit juice by mechanism-based inhibition of intestinal CYP3A4 suggest that other plant products may likewise cause interactions with drugs.
Nowack 2008
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Herbal medicines such as St. John's wort (Hypericum perforatum), garlic (Allium sativa), piperine, ginseng, gingko, soya beans (Glycine max), alfalfa and grape fruit juice show clinical interactions when co-administered with medicines.
Saxena 2008
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Clinically significant interactions of St. John's wort (SJW) often result in a decrease in the concentration or effect of the combined drug, most probably due to the induction of cytochrome P450s and the key drug transporter P-glycoprotein by the major active constituents in SJW.
Zhou 2008
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Safety aspects of some of the most frequently used plants are now well known. For example, hypericum should not be given to patients taking other drugs because of potential interactions.
Calapai 2007
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The extent to which community pharmacists and health food store clerks provide appropriate advice regarding a drug interaction between oral contraceptives and St. John's wort was estimated.
Sarino 2007
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Significant interactions of St. John's wort include decreased efficacy of antiretrovirals, cyclosporine, tacrolimus, antiepileptics, irinotecan, and other chemotherapeutic agents. Adverse events include nausea, headache, constipation, dizziness, confusion, fatigue and dry mouth.
[No authors listed] 2006
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[HIV patients taking antiretrovirals should avoid garlic, St. John's wort. Other health products were fine.]
[No authors listed] 2006
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St John's wort, a popular herbal antidepressant, increases clearance of many drugs, and abnormally low cyclosporine, digoxin, theophylline, or protease inhibitor concentrations may be observed in a patient taking any of these drugs in combination with St John's wort.
Dasgupta 2006
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The major St. John's wort constituents, acylphloroglucinols, were evaluated for their effects on cytochrome P450 3A4 enzyme activity to investigate their roles in herb-drug interaction.
Lee 2006
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Co-medication with St John's Wort resulted in decreased plasma concentrations of a number of drugs including amitriptyline, cyclosporine, digoxin, indinavir, irinotecan, warfarin, phenprocoumon, alprazolam, dextrometorphane, simvastatin, and oral contraceptives.
Madabushi 2006
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Some complementary and alternative medicines like kava-kava, vitamin E, quercetin, ginseng, garlic, beta-carotene, and Echinacea are capable of causing interactions with anticancer drugs.
Meijerman 2006
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It has been reported that the interactions between drugs and grapefruit juice or St John's wort are frequent. [Article in Spanish]
Morales-Olivas 2006
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St John's wort (SJW) found to decreases the blood concentration of ciclosporin A (CsA), which may result in allograft rejection and an optimal dosage regimens of CsA during and after the intake of SJW to prevent an adverse drug interaction between CsA and SJW was identified.
Murakami 2006
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St. John's Wort preparations should not be taken concurrently with other antidepressants, with coumarin-type anticoagulants, immuno-suppressants cyclosporine and tacrolimus, protease & reverse transcriptase inhibitors used in anti-HIV treatment or with certain antineoplastic agents.
Schulz 2006
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St John's wort was the first and most frequently reported source of induction-style herb-drug interactions and this type of interaction is likely to be relevant to other herbal products.
Tirona 2006
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Review on interactions that can compromise response to antiretroviral therapy indicates the main inducers of enzyme are antiepileptic drugs, tuberculostatic agents, the antiretroviral agents and some natural products such as St. John's wort (Hypericum). [Article in Spanish]
Tuset Creus 2006
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Several herbal medicines including Echinacea, garlic, ginkgo, milk thistle, and St. John's wort have the potential to cause significant interactions with antiretroviral drugs.
van den Bout-van den Beukel 2006
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It has been shown that since Ginkgo and onion contain quercetin and its glycosides as St. John's Wort and the coadministration of cyclosporin with ginkgo or onion may be subject to clinically relevant interactions as St. John's Wort.
Yang 2006
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[Herb-drug interactions. St. John's wort and prescription medications.]
Bressler 2005
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Review on interaction of warfarin with drugs, natural substances, and foods reveals that St. John's wort and possibly some ginseng formulations may have the potential to diminish warfarin anticoagulation, apparently by inducing CYP2C9 activity.
Greenblatt 2005
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Interactions are likely between herbal remedies with antiplatelet or nephrotoxic effects and NSAIDs, hepatotoxic herbal remedies and disease-modifying antirheumatic medication, and between St. John's Wort and cyclosporin.
Holden 2005
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Toxicity and drug interactions associated with herbal products like ephedra and St. John's Wort have been reviewed.
Holstege 2005
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Review on herb-drug interactions revealed that St. John's Wort decreased blood concentrations of ciclosporin, midazolam, tacrolimus, amitriptyline, digoxin,indinavir, warfarin, & theophylline, but did not alter pharmacokinetics of carbamazepine, pravastatin, mofetil mycophenolate & dextromethorphan.
Hu 2005
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Through induction of cytochrome P450 enzymes and/or P-glycoprotein, St John's wort has been shown to lower plasma concentration (and/or pharmacological effect) of a number of conventional drugs, including cyclosporine, indinavir, irinotecan, nevirapine, oral contraceptives & digoxin.
Izzo 2005
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Gum guar, St. John's wort, Siberian ginseng and wheat bran were found to decrease plasma digoxin concentration. Decreased plasma concentration of simvastatin or lovastatin was observed after co-administration with St. John's wort and wheat bran, respectively.
Izzo 2005a
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Review on clinical trials examining natural health product-HIV drug interactions and their methodological characteristics reveals that significant interactions were observed with St John's wort, garlic and vitamin C.
Mills 2005
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Potentially clinically significant drug interactions were observed with St. John wort (16/24 studies), garlic (2/5 studies), and American ginseng (1 study).
Mills 2005
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St. John's Wort (SJW) is associated with increased metabolism of norethindrone and ethinyl estradiol, breakthrough bleeding, follicle growth and ovulation & the women using oral contraceptives should be cautioned that SJW might interfere with contraceptive effectiveness.
Murphy 2005
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Investigation of the time-dependent effects of St. John's wort (SJW) on midazolam 1-hydroxylation in Wistar rats shows that it is important for persons receiving SJW for an extended time to consider its interactions with prescription drugs.
Qi 2005
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Hyperforin is an active ingredient of the herbal remedy St. John's wort, and activates gene transcription of cytochrome p450-3A4, causing significant botanical-drug interactions.
Shay 2005
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There is very little evidence to substantiate actual pharmacokinetic and/or pharmacodynamic interaction between drugs and kava or St. John's wort.
Singh 2005
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Only a few herbal drugs have been cited in interaction reports, for e.g.St John's Wort, Ginkgo biloba, Dan Shen,liquorice,Ma huang & garlic, & main drugs involved are those which are already susceptible to interactions with many other drugs, such as warfarin, protease inhibitors & anti-cancer drugs.
Williamson 2005
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[St John's wort-associated drug interactions: short-term inhibition and long-term induction?]
Xie 2005
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St John's wort reduces the efficacy of several drug groups including: immunosuppressants (risk of graft rejection), oral contraceptives (risk of pregnancy), oral anticoagulants (risk of thrombosis), and HIV protease inhibitors. It can also reduce the bioavailability of digoxin.
[No authors listed] 2004
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Clinically significant drug interactions of Atazanavir, the first once-daily protease inhibitor for the treatment of human immunodeficiency virus type 1 infection, include antacids, diltiazem, St. John's wort, and warfarin.
Busti 2004
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A total of 16.6% of children had a current or past history of ingestion of herbal medicines. A significant number of children had taken agents which may interact with anesthesia and surgery: St John's Wort, valerian, garlic and gingko.
Crowe 2004
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Review on food-drug interactions via human cytochrome P450 3A indicates that grapefruit juice interacts with felodipine and cyclosporine, red wine with cyclosporine, and St John's wort with various medicines including cyclosporine.
Fujita 2004
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When combined with serotonin reuptake inhibitor, antidepressants or buspirone, St John's wort can cause serotonergic syndrome.
Izzo 2004
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Hyperforin content of St John's wort (SJW) extracts significantly affects the extent of the pharmacokinetic interaction between cyclosporine and SJW.
Mai 2004
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Combinations of St John's wort with serotonergic agents and other antidepressants should be restricted to prescription-only, by experienced clinicians, due to potential central pharmacodynamic interactions.
Mannel 2004
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Systematic review of clinical trials on interactions of St John's wort with conventional drugs indicates that Clinicians and patients should beware of possible decreases in the systemic bioavailability of conventional drugs when taken concomitantly with St John's wort.
Mills 2004
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Black lipid membrane experiments were performed to investigate the effect of the ethanolic Hyperici herba extract on the electrical properties of artificial lipid bilayers.
Neagoe 2004
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[Induction of imatinib metabolism by hypericum perforatum.]
Smith 2004
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Coadministration of imatinib with St. John's wort in ten healthy adult volunteers may compromise imatinib's clinical efficacy.
Smith 2004
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Herbs with the potential to significantly modulate the activity of drug-metabolizing enzymes and/or the drug transporter P-glycoprotein include garlic, ginkgo, echinacea, ginseng, St John' s wort and kava.
Sparreboom 2004
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St John's wort was found to induce both CYP3A4-catalyzed sulfoxidation and CYP2C19-dependent hydroxylation of omeprazole and enormously decreases the plasma concentrations of omeprazole, in 12 healthy adult men.
Wang 2004
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Investigation of possible interactions of St John's wort extract & its constituents with transport activity of P-Glycoprotein (Pgp) suggests that plasma levels of constituents of St John's wort are very likely too low to interfere with Pgp at blood-brain-barrier with possible exception of quercetin.
Weber 2004
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It is indicated that Hypericum perforatum, an increasingly used herbal antidepressant drug should be used with caution due to severe and possibly dangerous interaction with cardioactive drugs.
Zellweger 2004
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St John's wort decreased the plasma concentration of the active metabolite SN-38 in cancer patients receiving irinotecan treatment. It caused breakthrough bleeding and unplanned pregnancies when used concomitantly with oral contraceptives.
Zhou 2004
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Various herbal supplements have been reported or are suspected to interact with certain oral health drugs, the most important one being kava, St. John's wort, chamomile, and valerian interacting with central nervous system (CNS) depressant drugs.
Abebe 2003
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[Drug interaction of herbal tea containing St. John's wort with cyclosporine.]
Alscher 2003
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Review on drug-herb interaction among commonly used conventional medicines, indicates that warfarin was the most common drug and St. John's wort was the most common herbal product reported in drug-herb interactions.
Brazier 2003
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Drugherb interactions can result in unexpected concentrations of therapeutic drugs. For example, low concentrations of several drugs (e.g., cyclosporine, theophylline, digoxin) can be observed in patients who initiated self-medication with St John's wort.
Dasgupta 2003
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Prescription of St. John's wort might decrease methadone blood levels and induce withdrawal symptoms which, if not correctly identified and handled (by changing the antidepressant or by increasing the methadone dose), might cause unnecessary discomfort to the patient.
Eich-Hochli 2003
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Interactions of grapefruit juice with cyclosporin and felodipine, St John's wort with cyclosporin and indinavir, and red wine with cyclosporin, have the potential to require dosage adjustment to maintain drug concentrations within their therapeutic windows.
Harris 2003
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The pharmacology of irinotecan is complicated by existence of genetic inter-individual differences in activation and deactivation enzymes of irinotecan (e.g., CYP3A4, CYP3A5, UGT1A1) & sharing competitive elimination pathways with many concomitant medications, including St. John's Wort.
Ma 2003
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Administration of St. John's wort extract to patients receiving tacrolimus (TAC) treatment can result in a serious drug interaction leading to reduced TAC blood concentrations associated with risk of organ rejection. But mycophenolic acid pharmacokinetics remained unaffected with hypericum.
Mai 2003
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Review on current St John's wort (SJW) research from mode of action to clinical efficacy confirmed the good tolerability of St. John's wort extract and the very low frequency of adverse events, however, some drug interactions have been found to occur with SJW extract.
Muller 2003
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It is suggested that most of the potential deleterious effects of natural products on unborn may be related to hormonal effects (e.g., phytoestrogens) and nutriceutical drug interactions (e.g., St. John's Wort & antidepressants), rather than direct embryotoxicity per se.
Rousseaux 2003
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[Dangerous interaction of St. John's wort with chemotherapy?] [Article in German]
Schmitt 2003
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[Unwanted pregnancy on self-medication with St John's wort despite hormonal contraception.]
Schwarz 2003
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Interactions between the herb St John's wort and the drugs such as cyclosporin, anticoagulants, digoxin, antidepressants and protease inhibitors have been reported.
Williamson 2003
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Review on herbal interactions with cardiovascular drugs reveals that
some herbs, including garlic, ginkgo, ginseng, and St John's wort, can have a significant influence on concurrently administered drugs.
Awang 2002
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St. John's Wort may potentiate certain enzymes of the cytochrome P450 enzyme system which resulted in a lowering of serum concentration of a number of concomitant drugs, including warfarin, digoxin, theophylline, cyclosporin, and indinavir.
Bilia 2002
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[Tacrolimus-induced nephrotoxicity unmasked by induction of the CYP3A4 system with St John's wort.]
Bolley 2002
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[Possible serotonin syndrome after combination of buspirone and St John's Wort.]
Dannawi 2002
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St. John's wort is efficacious for mild to moderate depression, but serious concerns exist about its interactions with several conventional drugs.
Ernst 2002
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5 independent computerized literature searches of reports of interactions of SJW with cyclosporine showing that SJW can endanger organ transplantations.
Ernst 2002
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St John's wort, for example, induces the expression of p-glycoprotein and CYP3A4 in liver and intestine and thereby decreases the activity of other drugs. [Article in German]
Fattinger 2002
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A number of clinically significant interactions of St John's wort have been identified with prescribed medicines including warfarin, phenprocoumon, cyclosporin, HIV protease inhibitors, theophylline, digoxin & oral contraceptives resulting in a decrease in concentration or effect of medicines.
Henderson 2002
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H. perforatum increased P-glycoprotein expression, P-glycoprotein mediated rhodamine efflux, and attenuated Ritonavir inhibited P-glycoprotein mediated efflux.
Hennessy 2002
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[Interactions of the oral contraceptive pill with antibiotics and St John's wort: knowledge of female college students.]
Hindmarch 2002
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Review of recent studies on interactions between SJW and other drugs including cyclosporine, indinavir, nevirapine, oral contraceptives, and amitriptyline.
Ioannides 2002
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An evidence-based literature review of 5 commonly used herbs in Denmark: St John's wort, ginkgo biloba, valerian, garlic, and ginseng has been presented. Attention to clinical practice & recommendations for discontinuation of the 5 herbs are given before surgery. [Article in Danish]
Kistorp 2002
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If inducers (e.g. rifampicin, anticonvulsants, St John's wort) or inhibitors (ketoconazole, grapefruit juice, etc.) of CYP3A4 are concomitantly administered pharmacokinetic interactions could be expected to a variable extent.
Klotz 2002
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Patients on irinotecan treatment should refrain from taking SJW because plasma levels of SN-38 were dramatically reduced.
Mathijssen 2002
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St. John's wort has been implicated as an inducer of the P450 enzyme system, and as such, may cause increased metabolism of certain drugs, including oral contraceptives. Women using oral contraceptives have been warned against using St. John's wort.
Murphy 2002
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Natural products that have been reported to interact with drugs in humans include coenzyme Q10, dong quai, ephedra, Ginkgo biloba, ginseng, glucosamine sulfate, ipriflavone, melatonin, and St. John's wort.
Scott 2002
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Review on interactions of herbal remedies with prescription cardiovascular medications shows that limited data exists regarding the efficacy of herbs such as echinacea, garlic, ginseng, gingko, ephedra, and St. John's wort.
Aggarwal 2001
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Review on the use of alternative pharmacotherapy (AP) in management of cardiovascular disease (CVD) indicates that some APs interact with common prescription CVD medications (eg, gingko and ginseng with warfarin, St. John's Wort with digoxin).
Chagan 2002
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Studies have shown that St. John's wort (SJW) (Hypericum perforatum) can reduce plasma levels of indinavir, cyclosporin, digoxin, and possibly other drugs as well. It has been reported that the P-glycoprotein transmembrane pump is also induced by SJW.
Cott 2001
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Review on herb-drug interactions and assessment of report reliability shows that among 180 cases of suspected interactions, warfarin was the most common drug (18 cases) and St John's wort the most common herb (54 cases) involved.
Fugh-Berman 2001
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St John's wort lowers blood concentrations of cyclosporin, amitriptyline, digoxin, indinavir, warfarin, phenprocoumon & theophylline & it causes intermenstrual bleeding, delirium or serotonin syndrome, when used with oral contraceptives, loperamide or serotonin-reuptake inhibitors.
Izzo 2001
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Psychopharmacologic interventions in transplant patients, including the use of antidepressant medication pre- & post-transplant, and interactions between over-the-counter and herbal agents (e.g., St. John's Wort) and immunosuppressive agents have been reviewed.
Jowsey 2001
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Examples of conventional medications which may undergo significant CYP 3A4 induction by St. John's wort include cyclosporine, indinavir, and oral contraceptives.
Markowitz 2001
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A kidney transplant recipient who developed marked reduction of cyclosporine therapeutic activity after the self-initiation of St. John's wort has been described.
Moschella 2001
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A kidney transplant recipient developed marked reduction of cyclosporine therapeutic activity after the self-initiation of St. John's wort.
Moschella 2001
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Reported case of irregular bleeding with oral contraception and SJW and discussion of drug interactions and the mechanisms.
Ratz 2001
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SJW decreases plasma concentrations of simvastatin but not of pravastatin probably due to the enhancement of the CYP3A4-mediated first-pass metabolism of simvastatin in the small intestine and liver.
Sugimoto 2001
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Many commonly ingested substances such as grapefruit juice and Hypericum perforatum (St John's wort) have been found to interact with important therapeutic agents such as cyclosporine.
Tsunoda 2001
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2 kidney transplant recipients started self-medicating with St John's wort causing significant reduction in cyclosporine concentrations.
Turton-Weeks 2001
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St. John's Wort can induce the CYP3A family of activation enzymes through which approximately 50% of drugs are metabolized. This poses some risk of inadvertently reducing the half-life of such drugs as indinavir, cyclosporin and cyclophosphamide.
Wargovich 2001
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Herbs like Ginkgo biloba, Piper methysticum (Kava-Kava), Glycyrrhiza glabra, Hypericum perforatum, Valeriana officinalis, Cannabis sativa, Salix alba, etc. have been included for the study of synergy and other interactions in phytomedicines.
Williamson 2001
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Review of reported interactions and reduced therapeutic activity with warfarin, cyclosporin, oral contraceptives, theophylline, fenprocoumon, digoxin & indinavir. Sudden discontinuance of hypericum may cause a rebound effect
Baede-van Dijk 2000
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"Drug interaction of St John's wort with cyclosporin " (letter, no abstract)
Breidenbach 2000
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Cyclosporin blood level fell 47% in 35 kidney transplant patients taking St. John's Wort. Cyclosporin dose was increased 46% to compensate and on discontinuation of the herb cyclosporin bounced up 187%
Breidenbach 2000
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Review finds decreased bioavailability of digoxin, theophylline, cyclosporin & phenprocoumon when combined with St John's wort and mild serotonin syndrome when combined with SSRI. Many interactions reports are sketchy and lack lab analysis
Fugh-Berman 2000
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"Pericon interactions " (Danish, no abstract)
Jensen 2000
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"Harmless herbs: a cause for concern? " (letter, no abstract)
Koupparis 2000
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Effect of Hypericum on P-450 was probed by urinary dextromethorphan (CYP2D6 activity) and alprazolam (CYP3A4 activity) in 7 people. No significant differences were found
Markowitz 2000
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Editorial summarizes reports of Hypericum's inhibition of CYP3A4 &/or p-glycoprotein and calls for a sense of proportion - keeping in mind that many ordinary fruits & vegetables have similar effects
McIntyre 2000
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"Interaction between indinavir and St. John's wort reported " (news report of Piscitelli)
Miller 2000
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Hyperforin is a potent ligand (K(i)=27 nM) for the pregnane X receptor, a nuclear receptor that regulates expression of CYP3A4 monooxygenase. Hyperforin induces CYP3A4 expression in human hepatocytes
Moore 2000
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"St. John's Wort: three cases of possible mania induction " (no abstract)
Moses 2000
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Antiimmobility effect of dry extract containing 0.3% hypericin & 3.8% hyperforin is completely suppressed by rimcazole pretreatment and reduced by 5, 7-dihydroxytryptamine in rats
Panocka 2000
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Indinavir (AIDS drug) plasma level area under the curve (AUC) was reduced 57% in 16 healthy volunteers after two weeks of 900 mg/d St John's Wort (0.3% hypericin)
Piscitelli 2000
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Urinary 6-beta-hydroxycortisol/cortisol ratio (a sign of CYP3A4 activity) increased from 7 to 13 in 13 people taking 900 mg/d for 14 days of an extract standardized to 0.3% hypericin
Roby 2000
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Acute rejection in two heart transplant patients due to a metabolic interaction of St John's wort and cyclosporin. Plasma cyclosporin levels returned to normal after Hypericum was discontinued
Ruschitzka 2000
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Synaptosome uptake inhibition by hyperforin of glutamate (Vmax 8.3 to 1.8 pmol) & GABA (Vmax 2.8 to 0.8 pmol). Effect is reduced by amiloride derivatives; mimiced but reduced by monesin or ouabain indicating role of Na+ channels
Wonnemann 2000
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Cyclosporin A or bongkrekic acid, inhibitors of mitochondrial permeability, don't protect cells from hypericin-induced mitochondrial permeability. Bcl-2 delays hypericin induced caspase-3 activation
Chaloupka 1999
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Review warns about interactions of Ginkgo with anticoagulants; St. John's wort with prescription antidepressants and effects on neurotransmitters; Ephedrine with cardiovascular events & seizures; Ginseng with warfarin
Cupp 1999
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Increased plasma growth hormone, decreased plasma prolactin and unchanged plasma cortisol in 12 healthy volunteers taking 9 tablets of Jarsin 300 (2700 mg LI160) possibly indicating effect on brain dopamine
Franklin 1999
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Reduction of animal models of depression by Hypericum is partially prevented by SCH 23390 (dopamine antagonist) or (-)-pindolol
Gambarana 1999
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Digoxin plasma level area under the curve (AUC) was unaffected at day one but reduced 25% after 10 days of 900 mg/d Hypericum (LI160) in healthy volunteers. This might be due to P-glycoprotein induction
Johne 1999
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Five cases of clinically diagnosed central serotonergic syndrome in elderly patients who combined prescription antidepressants with St. John's wort
Lantz 1999
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Omeprazole, an inhibitor of H+K+-ATPase, and amiloride, an inhibitor of the Na+/H+ exchanger, potentiate the effect of hypericin (microM) on HL-60 cells
Mirossay 1999
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Hypericin and pseudohypericin solubility are remarkably increased in the presence of a fraction containing procyanidins, especially procyanidin B2, which also significantly increased the in vivo effects
Butterweck 1998
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Fagopyrum esculentum (buckwheat) contains red fluorescent compounds having photosensitizing properties and spectrum similar to hypericin, inhibits kinases, PKC, EGF-R & Ins-R at ng/ml
Samel 1996
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Contraindications
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Cyclosporin blood level fell 49% in 45 kidney & liver transplant patients taking St. John's Wort leading to rejection episodes in two patients
Breidenbach 2000
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Patients on phenprocoumon or digoxin should not injudiciously discontinue St John's wort by themselves, as this could lead to toxic reactions of rebound in stabilised patients (comment on Ernst '99)
De Smet 2000
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P450 induction by Hypericum must be kept in perspective with other unregulated inducers like cruciferous vegetables, alcohol, smoke and inhibition by grapefruit. Labelling with precautions is appropriate (comment on Ernst '99)
Jobst 2000
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Pregnane X receptor, a regulator of P450 CYP3A4 monooxygenase expression in the nucleus, binds hyperforin (Ki=27 nM). Hepatocytes treated with hypericum extracts or hyperforin induced CYP3A4 expression
Moore 2000
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7 warfarin patients with increased bleeding time and 8 women with intermenstrual bleeding possibly due to increased metabolism of oral contraceptives induced by St John's Wort (comment on Ernst '99)
Yue 2000
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Review of the pharmacology, efficacy, safety, and pharmokinetics St. John's Wort, chromium, and garlic used for depression, diabetes, and hypercholesterolemia, respectively. Safety with renal patients is unstudied
Duncan 1999
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Pharmacology, precautions, therapeutic uses, and adverse effects of ginkgo biloba, St. John's wort, saw palmetto, and soy reviewed
Glisson 1999
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Hormonal effect raises concern about use by women and children
Klepser 1999
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"Potential metabolic interaction between St. John's wort and theophylline " (no abstract)
Nebel 1999
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A case of a woman switching from paroxetine (40 mg/d) to Hypericum (600 mg/d) for 10 days became lethargic after adding a 20 mg dose of paroxetine. She returned to normal the next day
Gordon 1998
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"St John's wort during pregnancy " (no abstract)
Grush 1998
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A measurable increease in erythema in light sensitive volunteers mainly after the highest dose, 600 mg 3 times daily for 15 days (11 mg hypericin). UV-A sensitivity increased from 10.8 J/cm2 to 8.7 J/cm2
Brockmoller 1997
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Animal Studies
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Administration of 500mg/kg of Saint Johns Wort in swim stressed rats increases intraneuronal 5-hydroxytryptamine metabolism but inhibits its release under adverse conditions proving its anxiolytic property.
Ara 2009
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The effect of Hypericum perforatum on the inflammatory and immune response of colonic mucosa in rat with induced inflammatory bowel disease and that on various enzyme activities in blood and bowel tissue was investigated.
Dost 2009
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The effects of Hypericum perforatum extract (HPE) on morphine withdrawal syndrome and comparison with clonidine have been investigated in morphine-dependent rats which revealed that HPE is capable of reducing the symptoms of opiate withdrawal.
Feily 2009
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The optimisation of biopharmaceutical properties of a dried commercial extract of St John's Wort were evaluated employing the in vivo forced swimming test.
Isacchi 2009
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Examination of the effects of Hypericum perforatum L. extracts on the naloxone-induced heroin withdrawal syndrome in rats shows it is capable of reducing the physical signs of opiate withdrawal.
Subhan 2009
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Serotoninergic 5-HT1A and 5-HT2A, alpha-adrenergic and dopaminergic D1 receptors are involved in the disruptive effect of St. John's wort extract on prepulse inhibition response in rats.
Tadros 2009
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The exacerbating effect of St. John's wort extract on prepulse inhibition (PPI) deficit seen in rats may provide a limitation for using the extract to manage cognitive disturbance in psychotic and Huntington's disease patients manifesting PPI deficit.
Tadros 2009
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An anxiogenic effect of Zn-deficiency prevented by chronic desipramine and Hypericum perforatum treatment was observed in the novelty suppressed feeding test, but not in other anxiety tests performed in mice.
Whittle 2009
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The usage of Oleum Hyperici (Hypericum perforatum) oil extract as an antiinflammatory and gastroprotective agent, which has been based previously only on ethnopharmacological claims have been proved by experimental models in rats.
Zduni?009
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The genotoxic effects of St. John's wort supplement in somatic and germ cells was determined and the role of biochemical changes, as a possible mechanism was investigated by oral treatment in mice.
Aleisa 2008
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St. John's wort treatment alters stress induced augmented 5-HT levels by decreasing precursor availability to the brain and serotonergic system is involved in the mechanism of action of the drug in rats subjected to swim stress.
Bano 2008
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It is indicated that hypericin, from Hypericum perforatum, is an effective photosensitizer not only after systemic administration, but also after topical application, on a normal mouse skin especially when applied as its precursor acetate ester.
Boiy 2008
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It is found that St. John's wort has a direct inhibitory effect on smooth muscle and could also possibly modulate gastric neurotransmission in rats. Orally administered SJW extract delayed gastric emptying in vivo.
Capasso 2008
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Hypericin and St. John's Wort reduce pathological retinal neovascularization and administration of these agents has clinical utility for treatment of ischemic retinopathies.
Higuchi 2008
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The effects of Urtica dioica, Plantago major and Hypericum perforatum herbal mixture in the MDP/collagen induced arthritis rat model was assessed which showed clinical therapeutic effect on the course of the clinical manifestations.
Khalifeh 2008
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An extract of the roots of Rhodiola rosea increased the swimming time of rats in a dose dependent manner and, when administered at 20mg/kg, exhibited a stronger anti-depressant type effect than either imipramine (at 30 mg/kg) or an extract of Hypericum perforatum (at 20mg/kg).
Panossian 2008
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Two animal behavioural studies examining the antidepressant effects of St. John's wort extract, rutin using Porsolt's forced swimming test and, in addition, the quercetin metabolite isorhamnetin was performed.
Paulke 2008
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Antitumor effects of peptide extracts from plants including Hypericum perforatum on slowly growing mammary adenocarcinoma in CBRB-Rb(8.17)1Iem mice used as a model of breast cancer in humans was studied.
Tepkeeva 2008
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The hypothesis that preventive administration of Hypericum perforatum may counteract the working memory impairments caused by repeated stress was tested in male Wistar rats which showed improved hippocampus dependent spatial working memory.
Trofimiuk 2008
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St. John's wort (SJW), Harpagophytum procumbens extract (HPE) and Grape seed proanthocyanidin extract (GSPE) exert significant antinociceptive effects in the formalin test of mice & opioidergic system seems to be involved in the antinociceptive effect of HPE but not SJW and GSPE.
Uchida 2008
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The effects of anti-depressants fluoxetine, venlafaxine, escitalopram, tianeptine, and extract of Hypericum perforatum that interact with the serotonergic system on signs of ethanol withdrawal syndrome in rats were examined and their use in this condition was confirmed.
Uzbay 2008
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A study was undertaken to explore the therapeutic potential of St. John's wort(SJW) on behavioral alterations & oxidative damage induced by sleep deprivation in mice which confirmed the therapeutic potential of SJW in management of sleep deprivation-induced anxiety-like behavior & oxidative damage.
Kumar 2007
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The possible involvement of serotonin (5-HT) in the beneficial effects of Hypericum perforatum on nicotine withdrawal signs was investigated in mice and confirmed.
Mannucci 2007
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It has been shown that Hypericum perforatum extract has neuromodulating effect against 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine induced Parkinson's disease in mice.
Mohanasundari 2007
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Standardized Hypericum perforatum reduces oxidative stress and increases gene expression of antioxidant enzymes on rats exposed to rotenone intraperitoneally for 45 days.
S?hez-Reus 2007
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Ethanol extracts of the aerial parts of six Hypericum species, produced antiinflammatory activity, particularly those from Hypericum hirsutum, and both wild and cultivated H. perforatum in carrageenan-induced rat paw edema model.
Savikin 2007
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The preventive effect of St John's Wort (SJW) on cisplatin nephrotoxicity in rats was reported and suggested that pre-treatment with SJW may diminish cisplatin nephrotoxicity.
Shibayama 2007
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3 preparations of Hypericum perforatum L. & the compounds hypericin, hyperforin, adhyperforin, amentoflavone, hyperoside, isoquercitrin, dicyclohexylammonium salt & its amine were evaluated for their topical anti-inflammatory activity in Croton-oil-induced ear oedema in mice.
Sosa 2007
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Hydro-ethanolic extract of Hypericum perforatum Linn. (St. John?s Wort) aerial parts were studied for possible antinociceptive effect against acetic acid-induced abdominal constrictions in mice which revealed its antinociceptive action, the effect of which was antagonized by naloxone.
Subhan 2007
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The in vivo effectiveness of hyperforin, a concentrated extract of Hypericum perforatum was studied in an experimental model for the expulsion phase of ejaculation in anesthetized rats and its effect in a rat model of ejaculation was confirmed.
Thomas 2007
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It is suggested that extract of Hypericum perforatum blocks caffeine-induced locomotor hyperactivity in mice.
Uzbay 2007
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The leucopenia caused by some chemotherapeutic agents in rats can be modified by dietary supplementation with vitamin E and St. John's wort had neither a beneficial nor a detrimental effect on chemotherapy-induced toxicity.
Branda 2006
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Hypericum perforatum extract (25-200 mg/kg) produced inhibitory effects on locomotor hyperactivity and reduced the number of stereotyped behaviors on ethanol withdrawal in male Wistar rats at second and sixth hour.
Coskun 2006
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In Wistar rats, the effect of a treatment with high doses of SJW extract (100 and 1000 mg/kg/day) administered prenatally and during breastfeeding, on the level of transcripts of mdr1a, mdr1b, mrp1, mrp2 and cyp3A2 genes was investigated.
Garrovo 2006
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The evaluation of the antioxidant effect of Hypericum perforatum in an experimental animal model of spinal cord injury, which was induced by the application of vascular clips to the dura via a four-level T5 through T8 laminectomy showed that it ameliorated the recovery of limb function.
Genovese 2006
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Hypericum perforatum extract reduces the development of acute pancreatitis induced by cerulein administration in male CD mice.
Genovese 2006a
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Using open field stress as a psychological stressor to induce hyperthermia in mice it was able to detect putative anxiolytic effects of St John's wort extract and its single constituents.
Grundmann 2006
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The combined treatment of bromocriptine (BRC) and Hypericum perforatum extract (HPE) in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinson's disease in male Swiss Albino mice was more pronounced than BRC or HPE alone.
Mohanasundari 2006
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Drugs that reliably decrease alcohol intake in the inbred Fawn-Hooded rats include 5-hydroxytryptamine-2A receptor antagonist, amperozide, the mGlu5 receptor antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) and herbal derivatives such as ibogaine, St. John's wort and kudzu extract.
Overstreet 2006
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Hypericum perforatum extract found to attenuate the degree of zymosan-induced multiple organ dysfunction syndrome in mice.
Paola 2006
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St John's wort extract and fluoxetine elevated brain and plasma corticosterone concentrations after subchronic treatment and St John's wort is the only antidepressant tested which slightly elevated P-glycoprotein level in the brain of mice.
Weber 2006
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Hypericum perforatum exhibits antiedematogenic and antinociceptive properties in rats, which may be of value for the management of inflammatory painful conditions.
Abdel-Salam 2005
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Fractionated administration of hypericin in C3H/DiSn mice found to produce a better antitumour effect than single administration.
Cavarga 2005
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The ester derivative IDN 5491 (hyperforin-trimethoxybenzoate) showed antidepressant-like properties in the forced swimming test (FST) in rats, with no effect on open-field activity, when given as three intraperitoneal injections in 24 h at 3.125 and 6.25 mg/kg.
Cervo 2005
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A 15-day oral treatment of male rats with Echinacea purpurea and Hypericum perforatum at the higher dose significantly inhibits prolactin production.
Di Carlo 2005
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It is suggested based on studies conducted on rats that the antidepressant action of Hypericum perforatum is not mediated by a circadian mechanism.
Francis 2005
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Aristoforin, a novel stable derivative of hyperforin, retains the antitumor properties of the parental compound without inducing toxicity in experimental animals.
Gartner 2005
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Co-administered St. John's Wort (SJW) significantly ameliorated the toxicities induced by CPT-11 in rats and the protective effect of SJW is partially due to pharmacokinetic interaction between CPT-11 and SJW.
Hu 2005
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Nelumbinis Semen provides greater anti-depression effects than Hypericum Perforatum in rats and the effects might be due to the modulation of the amount of neurotransmitters involved in depression.
Kang 2005
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St. John's wort extract at 500 mg/kg in rats reduced prepulse inhibition response through enhancing monoaminergic transmission in brainstem, thalamus, cortex and/or hippocampus.
Khalifa 2005
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The selective and pronounced effect of CO2 Hypericum perforatum extract, alone or combined with naltrexone, on ethanol intake in conditions of chronic treatment, without development of tolerance in rats was demonstrated.
Perfumi 2005
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CO(2) Hypericum perforatum extract, markedly reduces the reinforcing properties of ethanol in the self-administration paradigm, as well as the increase of ethanol intake following ethanol deprivation in alcohol-preferring rats.
Perfumi 2005a
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The effect of a Hypericum perforatum extract on the labeling of blood elements with technetium-99m and in the bioavailability of the radiopharmaceutical sodium pertechnetate in Wistar rats revealed its effect on erythrocytes and plasma and cellular proteins. [Article in Portuguese]
Santos-Filho 2005
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It was observed that Hypericum perforatum prevented the deleterious effects of both chronic restraint stress and long-term corticosterone on learning and memory as measured in both, the object recognition and the water maze tests carried out with rats.
Trofimiuk 2005
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The total flavonoids in St. John's Wort decreased activity of monoamine oxidase,inhibited ptosis & attenuation of autonomous behavior induced by reserpine respectively, and it was shown to inhibit behavioral despair & acquired helplessness & to prolong the sleep time in mice.[Article in Chinese]
Xu 2005
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The hypocholesterolemic effects of a flavonoid-rich extract of St.John's Wort in Wistar rats might be due to its abilities to lower serum total cholesterol, total triglycerides, & LDL cholesterol levels as well as to slow the lipid peroxidation process & to enhance the antioxidant enzyme activity.
Zou 2005
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The investigation of the antidepressant effect of Hypericum perforatum at doses 7, 35 and 70 mg kg(-1) b. m.) was described on mice using the forced-swimming and tail-suspension methods.
Bach-Rojecky 2004
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The intraperitoneal administration of 30-100 mg/kg of St. John's Wort preparation in adult albino mice produced significant analgesic effect (75%) in acetic acid induced writhing and formalin licking tests.
Bukhari 2004
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The two different commercially available Brazilian hydroalcoholic Hypericum perforatum extracts did not show the expected effects in a screening test for antidepressant agents, on the contrary, one of the extracts promoted a depressant-like effect in rats, in the forced swimming test.
Guilhermano 2004
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In the rats treated with multiple administrations (15 mg/kg/d) of St. John's wort extract (SJW) for 2 weeks, the plasma concentration of nifedipine (NF) after oral administration was significantly decreased.
Kobayashi 2004
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St. John's Wort given at a dose of 400 mg/kg/day in rats for 30 days induces hepatic multidrug resistance protein 2, glutathione S-transferase-P and cytochrome P450 1A2, overexpressions, and thus, it could affect drug metabolism, conjugation and disposition.
Shibayama 2004
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Magnesium-depletion leads to enhanced depression- and anxiety-related behavior in mice and was further validated by the reversibility of the behavioral changes by desipramine and Hypericum perforatum extract.
Singewald 2004
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Hypericum perforatum extract at 300 mg/kg, p.o, exerts an acute anxiolytic drug effect in mice on the marble-burying test, which could indicate a potential anti-obsessive effect, although the development of tolerance could be an important drawback.
Skalisz 2004
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Evaluation of the effect of acute, subchronic (7 days), and chronic (21 days) Hypericum perforatum (150 and 300 mg/kg) extract administration in mice submitted to the mouse defense test battery, suggest anxiolytic-like and antipanic-like effects of H. perforatum extract.
Beijamini 2003
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The putative antipanic/anxiolytic effect of standardised Hypericum perforatum extract (LI 160) on rats tested in the elevated T-maze, an animal model of innate (panic) and learned (generalised) anxiety, at doses that exhibit antidepressant-like activity was evaluated.
Beijamini 2003a
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The roles of shade, fleece length and wool type in the protection of sheep from Hypericum perforatum poisoning was investigated and it was found that the ability of ruminant livestock to safely ingest Hypericum is determined by the amount of skin protection they have against incident sunlight.
Bourke 2003
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It is shown that an St. John's wort extract (SJW) free of hyperforin and hypericin exerts antidepressant activity in behavioral models, and the flavonoids are part of the constituents responsible for the therapeutic efficacy of SJW extracts.
Butterweck 2003a
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Investigation of the effects of an extract of Hypericum perforatum (Ph-50) on withdrawal signs produced by nicotine abstinence in mice reveals that treatment with Ph-50 attenuates nicotine withdrawal signs in mice.
Catania 2003
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The review summarizes the findings of the effects on alcohol intake in alcohol-preferring rats of extracts or purified compounds from two of the most promising herbs: kudzu (Pueraria lobata) and St. John's Wort (Hypericum perforatum).
Overstreet 2003
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It is found that Hypericum perforatum CO2 extract and opiate receptor antagonists act synergistically to induce a pronounced and selective reduction of voluntary ethanol consumption in alcohol-preferring rats.
Perfumi 2003
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It is clear that pure compounds (daidzin, puerarin), extracts from St. John's wort, ibogaine and an ibogaine analog suppress alcohol intake in animal models of excessive drinking with minimal effects on other appetitive behaviors.
Rezvani 2003
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Ethanol extracts of sect. Hypericum medicinal plants significantly shortened motionless time of mice forced swimming & espair time of mouse tail suspension in the two behavior despair animal models of depression. The effect of H. faberi was weaker than that of H. perforatum. [Article in Chinese]
Wan 2003
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It is suggested that the effects of Hypericum perforatum extracts on alcohol drinking behaviour of alcohol-preferring rats are due to the hyperforin content of the herb rather than to other, more polar constituents.
Wright 2003
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H. perforatum administered to mice for 4 days did not affect catalytic activities of CYP1A2, CYP2E1 and CYP3A and caused no significant change in the polypeptide levels.
Bray 2002
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Low doses of hyperforin stimulate striatal ACh release by an unknown mechanism, whereas high doses inhibit synaptic choline uptake and ACh release in mice.
Buchholzer 2002
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Long-term, but not short-term, administration to rats of Hypericum extract and hypericin modify levels of neurotransmitters in brain regions involved in the pathophysiology of depression.
Butterweck 2002
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H. perforatum extract alone failed to offer neuroprotection to injured retinal ganglion cells but when mixed with Panax quinquefolius extract and Ginkgo biloba extract significantly augmented survival and regeneration.
Cheung 2002
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In rats submitted to elevated T-maze, light/dark transition, and cat odor test, H. perforatum exerted anxiolytic-like effects in a specific subset of defensive behaviors, particularly those related to generalized anxiety.
Flausino 2002
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The most polar constituents of crude ethanol extract of Hypericum perforatum exerted highest antiepileptic activity in Chinchilla rabbits. Lipid-soluble constituents in ether fraction potentated epileptic activity.
Ivetic 2002
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Indian Hypericum perforatum treatment caused a significant decrease in the binding of [3H] spiroperone (DA-D2 receptor) to the striatum and increase in the binding of [3H] ketanserin (5-HT2A receptor) and [3H] flunitrazepam (BDZ receptor) to the frontal cortex in rats.
Kumar 2002
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