Titre du document / Document title

St John's wort (Hypericum perforatum L.) : a review of its chemistry, pharmacology and clinical properties

Auteur(s) / Author(s)

BARNES Joanne ⁽¹⁾ ; ANDERSON Linda A. ⁽²⁾ ; PHILLIPSON J. David ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Centre for Pharmacognosy & Phytotherapy, School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, ROYAUME-UNI
⁽²⁾ Medicines Control Agency, 1 Nine Elms Lane, London, ROYAUME-UNI

Résumé / Abstract

The chemical composition of St. John's wort has been well-studied. Documented pharmacological activities, including antidepressant, antiviral, and antibacterial effects, provide supporting evidence for several of the traditional uses stated for St John's wort. Many pharmacological activities appear to be attributable to hypericin and to the flavonoid constituents; hypericin is also reported to be responsible for the photosensitive reactions that have been documented for St. John's wort. With regard to the antidepressant effects of St John's wort, hyperforin, rather than hypericin as originally thought, has emerged as one of the major constituents responsible for antidepressant activity. Further research is required to determine which other constituents contribute to the antidepressant effect. Evidence from randomised controlled trials has confirmed the efficacy of St John's wort extracts over placebo in the treatment of mild-to-moderately severe depression. Other randomised controlled studies have provided some evidence that St John's wort extracts are as effective as some standard antidepressants in mild-to-moderate depression. There is still a need for further trials to assess the efficacy of St John's wort extracts, compared with that of standard antidepressants, particularly newer antidepressant agents, such as the selective serotonin reuptake inhibitors (recent comparative studies with fluoxetine and sertraline have been conducted). Also, there is a need for further studies in well-defined groups of patients, in different types of depression, and conducted over longer periods in order to determine long-term safety. St John's wort does appear to have a more favourable short-term safety profile than do standard antidepressants, a factor that is likely to be important in patients continuing to take medication. Concerns have been raised over interactions between St John's wort and certain prescribed medicines (including warfarin, ciclosporin, theophylline, digoxin, HIV protease inhibitors, anticonvulsants, selective serotonin reuptake inhibitors, triptans, oral contraceptives); advice is that patients taking these medicines should stop taking St John's wort, generally after seeking professional advice as dose adjustment of conventional treatment may be necessary.

Revue / Journal Title

Journal of pharmacy and pharmacology   ISSN 0022-3573   CODEN JPPMAB 

Source / Source

2001, vol. 53, n^o5, pp. 583-600 (4 p.1/2)

Langue / Language

Anglais

Editeur / Publisher

Pharmaceutical Press, Wallingford, ROYAUME-UNI  (1949) (Revue)

Mots-clés anglais / English Keywords

Plant origin ; Pharmacognosy ; Medicinal plant ; Depression ; Viral disease ; In vivo ; In vitro ; Hypericum perforatum ; Review ; Mechanism of action ; Flavonoid ; Clinical trial ; Biological activity ; Antidepressant agent ; Psychotropic ; Animal ; Human ; Toxicity ; Drug interaction ; Antibacterial agent ; Treatment ; Phytotherapy ; Controlled therapeutic trial ; Antiviral ; Pharmacokinetics ; Infection ; Guttiferae ; Dicotyledones ; Angiospermae ; Spermatophyta ; Mood disorder ;

Mots-clés français / French Keywords

Origine végétale ; Pharmacognosie ; Plante médicinale ; Etat dépressif ; Virose ; In vivo ; In vitro ; Hypericum perforatum ; Article synthèse ; Mécanisme action ; Flavonoïde ; Essai clinique ; Activité biologique ; Antidépresseur ; Psychotrope ; Animal ; Homme ; Toxicité ; Interaction médicamenteuse ; Antibactérien ; Traitement ; Phytothérapie ; Essai thérapeutique contrôlé ; Antiviral ; Pharmacocinétique ; Hypéricine ; Infection ; Guttiferae ; Dicotyledones ; Angiospermae ; Spermatophyta ; Trouble humeur ;

Mots-clés espagnols / Spanish Keywords

Origen vegetal ; Farmacognosia ; Planta medicinal ; Estado depresivo ; Virosis ; In vivo ; In vitro ; Hypericum perforatum ; Artículo síntesis ; Mecanismo acción ; Flavonoide ; Ensayo clínico ; Actividad biológica ; Antidepresor ; Psicotropo ; Animal ; Hombre ; Toxicidad ; Interacción medicamentosa ; Antibacteriano ; Tratamiento ; Fitoterapia ; Ensayo terapéutico controlado ; Antiviral ; Farmacocinética ; Infección ; Guttiferae ; Dicotyledones ; Angiospermae ; Spermatophyta ; Trastorno humor ;

Localisation / Location

INIST-CNRS, Cote INIST : 984, 35400009763401.0010