Herbal medicinal products in the treatment of depression

• Main Author: Petrović Silvana
• Format: Article
• Language: srp
• Published: Pharmaceutical Association of Serbia, Belgrade, Serbia 2017-01-01
• Series: Arhiv za farmaciju
• Subjects: st. john's wort herb - hyperici herba; herbal drugs for the treatment of depression; quality; efficacy and mechanisms of action; safety
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/0004-1963/2017/0004-19631705302P.pdf
• ISSN: 0004-1963; 2217-8767

For dry hydroalcoholic extracts of St. John's wort herb, Hyperici herba (Hypericum perforatum, Hypericaceae), it was demonstrated in clinical trials that in the treatment of mild to moderate (but not severe) major depression, they are more effective than placebo, and as effective as some standard antidepressants. These extracts represent complex mixtures of structurally diverse constituents with various mechanisms of action. The quantity of active components can vary among different extracts. The Committee on Herbal Medicinal Products of the European Medicines Agency (EMA/HMPC) published monograph on St. John's wort herb, Hyperici herba, according to which these extracts are the components of herbal medicinal products with well-established medicinal use of the active substance, intended for the treatment of mild to moderate depressive episodes and for the short term treatment of symptoms in mild depressive disorders. These herbal drugs are characterized by good tolerability. Compared to synthetic antidepressants, they cause less undesirable effects. However, they exhibit interactions with the large number of drugs, due to the induction of the isoenzymes of cytochrome P450 system (CYP, primarily CYP3A4) and P-glycoprotein, as well as the potentiation of serotonergic effects. Because of mentioned interactions, for these herbal drugs appropriate contraindications, special warnings and precautions for use were established.