depression abstract

[Guest guest]

The first large-scale U.S. trial of St. John's wort was completed this

spring.

Sponsored by Pfizer (which makes the antidepressant Zoloft), the study's

results were presented at the annual meeting of the American Psychiatric

Association on May 17, 2000, by the lead investigator, Richard C. Shelton

of Vanderbilt University. The study abstract is not published online. Here

are the details available thus far:

200 outpatients with major depression (SCID-DSM-IV), who were healthy,

free of psychotropic drugs at the beginning of the study, and who had a

baseline 17-item-Ham-D score of greater than 19 were recruited at 11 U.S.

university medical centers. They were randomly assigned either a placebo

or 900mg a day of a standardized St. John's wort extract (LI-160) for eight

weeks. If there was not an adequate response to 900 mg a day of St. John's

wort after four weeks, the dose was then advanced to 1200 mg a day.

Assessments included the HAM-D,Ham-A, BDI, and CGI. "The data

suggest that SJW is no more effective than placebo in patients with major

depression of at least moderate severity." The rate of side effects

from SJW

appeared to be no different from the placebo.

--

 

Chinese Herbal Medicine

 

FAX:

 

[Guest guest]

The first large-scale U.S. trial of St. John's wort was completed this spring. Sponsored by Pfizer (which makes the antidepressant Zoloft),

>>>>>This makes me wander

Alon

 

-

cha

Saturday, April 21, 2001 1:48 PM

depression abstract

The first large-scale U.S. trial of St. John's wort was completed this spring. Sponsored by Pfizer (which makes the antidepressant Zoloft), the study's results were presented at the annual meeting of the American Psychiatric Association on May 17, 2000, by the lead investigator, Richard C. Shelton of Vanderbilt University. The study abstract is not published online. Here are the details available thus far: 200 outpatients with major depression (SCID-DSM-IV), who were healthy, free of psychotropic drugs at the beginning of the study, and who had a baseline 17-item-Ham-D score of greater than 19 were recruited at 11 U.S. university medical centers. They were randomly assigned either a placebo or 900mg a day of a standardized St. John's wort extract (LI-160) for eight weeks. If there was not an adequate response to 900 mg a day of St. John's wort after four weeks, the dose was then advanced to 1200 mg a day. Assessments included the HAM-D,Ham-A, BDI, and CGI. "The data suggest that SJW is no more effective than placebo in patients with major depression of at least moderate severity." The rate of side effects from SJW appeared to be no different from the placebo. -- Director Chinese Herbal Medicine FAX: Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

On Saturday, April 21, 2001, at 03:11 PM, <alonmarcus wrote:

 

> The first large-scale U.S. trial of St. John's wort was completed this

> spring.

>                            Sponsored by Pfizer (which makes the

> antidepressant Zoloft),

> >>>>>This makes me wander

> Alon

>

It also makes me wonder when a company selling a competing

antidepressant drug threatened by sales of an herbal competitor sponsors

the research. There are many subtle factors in studies that can bias

the result.

 

At the same time, one has to ask, can we use herbs like drugs to treat

serious diseases? Also, we treat patterns. . . .and each patient with

depression has other symptoms that have to be considered. This will

influence responses. The " st. johnswort vs. antidepressant " boxing

match was decided before st. johnswort entered the ring.

 

In Chinese medicine, single medicinals are rarely used, especially for

such complex conditions as depression. We shouldn't be surprised at

such results. Pharmaceutical drugs are much stronger than simples

(herbs), and will always have a more dramatic effect, even if with side

effects.

 

 

[Guest guest]

, <alonmarcus@w...> wrote:

> The first large-scale U.S. trial of St. John's wort was completed this spring.

> Sponsored by Pfizer (which makes the antidepressant

Zoloft),

> >>>>>This makes me wander

 

 

Good point. I glossed over that.

 

[Guest guest]

Don't forget that Triptophan was discredited because of its association

with a tainted manufacturing process, not because it was harmful in

itself.

 

Hasn't anyone in the media raised any suspicion of the obvious conflict

of interest? Or do the advertising dollars matter more?

 

 

, @i... wrote:

> , <alonmarcus@w...> wrote:

> > The first large-scale U.S. trial of St. John's wort was completed this

spring.

> > Sponsored by Pfizer (which makes the

antidepressant Zoloft),

> > >>>>>This makes me wander

>

>

> Good point. I glossed over that.

>

 

[Guest guest]

Hasn't anyone in the media raised any suspicion of the obvious conflict of interest? Or do the advertising dollars matter more

>>>>Lets not forget that all of the research on herbs is usually done by manufactures as well. That is the reason we need something like an FDA. Personally I am looking for studies by NIH. The study done on Ginkgo showing that is was not effective for memory in the elderly made this point. It was the first study to make the placebo pill taste like Ginkgo. Good quality studies will support some of our believes and destroy many of them

Alon

[Guest guest]

 

thanks for posting this information about the SJW study. You’ve stated that the abstract is not

published online, so where did these details come from? I am always interested to see what

effect size the placebo and treatment groups actually had in studies like

this. Its usually not exactly the

same, so how different was it I wonder.

Does “no different than placebo” mean a statistical significance

anywhere above p<.05 ??

 

I believe

that studies using single ingredient products are a buy-in to imposing the same

chemical component for inducing, reducing, or blocking a physiological

mechanism model that is aimed at changing a symptom pattern without addressing

the cause of the problem. When a

pathological condition is the result of a more intertwined or complex pattern, patent

formulations like Alan Ben..’s IBS can address the more common elements of

those patterns without a differential diagnosis, in my opinion. A differential diagnosis can be pushed

to varied levels of differentiation.

So how far does differentiation need to be taken in order to demonstrate

an effect size that is clearly larger than placebo. Certain complex patterns are more suited to treatment with a

single well-designed formula, others require more expert individual assessment.

An example of a difficult pathology to effect with one formula would be a

condition where half the people tended to be complicated by phlegm and the

other half by dryness yet the same generally defined pathology (i.e. hypertension)

resulted. (I’m not suggesting that half the hypertension patients either have

dryness or phlegm). If this

group were to undertake an informal research study on Chinese herbs I believe

it would need to decide to either 1) use a well thought out formula, targeting

a condition that involves a complex pattern that fairly consistently presents

itself in a certain way, or 2) rely on individualization of formulas – but having

2 to 4 base formulas for predefined diagnoses that can be adjusted by a limited

number of ingredients - and differential diagnoses. I would suggest using the

same source for the herbs of any practitioners who participate. By using the data from this type of

study a more controlled study could be designed and implemented that would have

a much more predictable outcome.

For one, the effect size could be estimated. Effect size is very useful in estimating how large the controlled

study would need to be in order to improve the chances of obtaining statistical

significance. It’s a lot of work

to manage this type of process but I thought I heard Todd volunteering in some

way…

 

Stephen

Morrissey

 

 

-----Original

Message-----

Saturday, April 21, 2001

2:48 PM

cha

 

depression abstract

 

The first large-scale U.S. trial of St. John's wort was completed this spring.

Sponsored by Pfizer (which makes the antidepressant Zoloft), the study's

results were presented at the annual meeting of the American Psychiatric

Association on May 17, 2000, by the lead investigator, Richard C. Shelton

of Vanderbilt University. The study abstract is not published online. Here

are the details available thus far:

200 outpatients with major depression (SCID-DSM-IV), who were healthy,

free of psychotropic drugs at the beginning of the study, and who had a

baseline 17-item-Ham-D score of greater than 19 were recruited at 11 U.S.

university medical centers. They were randomly assigned either a placebo

or 900mg a day of a standardized St. John's wort extract (LI-160) for eight

weeks. If there was not an adequate response to 900 mg a day of St. John's

wort after four weeks, the dose was then advanced to 1200 mg a day.

Assessments included the HAM-D,Ham-A, BDI, and CGI. " The data

suggest that SJW is no more effective than placebo in patients with major

depression of at least moderate severity. " The rate of side

effects from SJW

appeared to be no different from the placebo.

--

Chinese Herbal Medicine

 

 

FAX:

 

 

The Chinese Herb

Academy, a voluntary organization of licensed healthcare practitioners,

matriculated students and postgraduate academics specializing in Chinese Herbal

Medicine, provides a variety of professional services, including board approved

online continuing education.

 

 

 

Your use of

is subject to the

Terms of Service.