The completed studies are important, but data are limited. The doses in the European studies were not standardized and the trial lengths not sufficiently long to yield definitive evidence that St. John's wort is superior to placebo. The inclusion criteria for patients also varied. NIMH concluded that studies should also assess the risk of relapse and the occurrence of side effects that may occur with long-term use. Since St. John's wort is not a proven therapy for depression, there is some risk in using it.
Clinical depression is a serious medical disorder that can be debilitating and can lead to suicide.
Currently the effective, proven treatments are antidepressants, short-term specific psychotherapies, or a combination of both. Since other medical conditions, such as thyroid disorders, can also mimic depression, anyone with symptoms of depression should receive a thorough medical examination to rule out other possible causes of the symptoms. The clinical trial is being coordinated at Duke University Medical Center in Durham, North Carolina, by Jonathan Davidson, M.D., and will include about 10 sites in various parts of the country. When the sites are identified by the end of 1997, individuals may contact Duke University Medical Center. Anyone who lives near a site or is willing to travel may apply.