Major depression is a common, debilitating and potentially life-threatening disorder. Major depression is a common disorder in both children and adolescents. Although many pharmaceutical antidepressants have been shown to have efficacy in ameliorating symptoms of depression in adults, there is currently no pharmaceutical antidepressant that has been indicated in the United States for use in children or adolescents. The extract from the plant Hypericum perforatum is commonly referred to as St. John's Wort (SJW). SJW is a popular naturotherapy treatment for depression in Germany. SJW has recently received significant attention in this country in both the scientific and lay media as a possible non-pharmaceutical treatment for depression. Numerous double-blind studies have indicated that SJW is superior to placebo in reducing symptoms in depressed adults. Controlled studies in adults have also described that SJW has similar antidepressant effects as pharmaceutical antidepressants, but SJW possesses a superior side effect profile. However, previously published studies of SJW in adults have generally had methodological shortcomings. These methodological considerations have prevented definitive conclusions to be drawn about the efficacy of SJW in adults with major depression. Naturotherapy and other forms of alternative medicine are often administered to children and adolescents (including SJW). We have found that there is great interest in SJW as a possible treatment for depression in the young. Anecdotally, parents who have administered SJW to their dysphoric children have described significant therapeutic benefit from SJW. Unfortunately, there are few data to support or refute the use of SJW in the young. There are currently no scientific studies or reports which have described the use of SJW in either children or adolescents. The purpose of this project is to examine the effectiveness, safety, and tolerability of SJW in both children and adolescents. This will be done by performing an exploratory, open-label, 8-week, flexible-dose study of SJW in youths ages 6-16 years. If shown to be a promising treatment for depressed youths, this work will provide the necessary data to inform the design of a randomized clinical trial.
|Findling, Robert L; McNamara, Nora K; O'Riordan, Mary Ann et al. (2003) An open-label pilot study of St. John's wort in juvenile depression. J Am Acad Child Adolesc Psychiatry 42:908-14|