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St. John's wort and Kava in treating major depressive disorder with comorbid anxiety: a randomised double‐blind placebo‐controlled pilot trial
Author(s) -
Sarris Jerome,
Kavanagh David J.,
Deed Gary,
Bone Kerry M.
Publication year - 2009
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.994
Subject(s) - placebo , kava , anxiety , major depressive disorder , beck anxiety inventory , randomized controlled trial , depression (economics) , antidepressant , psychiatry , double blind , crossover study , medicine , hypericum , psychology , beck depression inventory , traditional medicine , alternative medicine , pathology , economics , macroeconomics , cognition
Objective We report the first randomised controlled trial (RCT) using a combination of St. John's wort (SJW) and Kava for the treatment of major depressive disorder (MDD) with comorbid anxiety. Methods Twenty‐eight adults with MDD and co‐occurring anxiety were recruited for a double‐blind RCT. After a placebo run‐in of 2 weeks, the trial had a crossover design testing SJW and Kava against placebo over two controlled phases, each of 4 weeks. The primary analyses used intention‐to‐treat and completer analyses. Results On both intention‐to‐treat ( p = 0.047) and completer analyses ( p = 0.003), SJW and Kava gave a significantly greater reduction in self‐reported depression on the Beck Depression Inventory (BDI‐II) over placebo in the first controlled phase. However, in the crossover phase, a replication of those effects in the delayed medication group did not occur. Nor were there significant effects on anxiety or quality of life. Conclusion There was some evidence of antidepressant effects using SJW and Kava in a small sample with comorbid anxiety. Possible explanations for the absence of anxiolysis may include a potential interaction with SJW, the presence of depression, or an inadequate dose of Kava. Copyright © 2008 John Wiley & Sons, Ltd.