PICO Amanda DiMaria

Question In patients diagnosed with major depressive disorder, is St. John’s Wort a more effective treatment for treating depression compared with a placebo or a standard antidepressive treatment such as sertraline?

St. John’s Wort a herbaceous plant or shrub used in medicinal preparations to treat various disorders, including depression.




Sertraline Common Brands: Zoloft A prescription used to treat: depression obsessive-compulsive disorder (OCD) posttraumatic stress disorder (PTSD) premenstrual dysphoric disorder (PMDD) social anxiety disorder panic disorder

Article Title: The impact of missing data on clinical trials: a re-analysis of a placebo controlled trial of hypericum perforatum and sertraline in major depressive disorder Academic Journal: Psychopharmacology Year of Study: 2014

Problem Hypericum Perforatum (St John's Wort), is an herbal remedy used in the treatment of depression It was believed to be more effective than placebo in treating depression and to have fewer side effects than standard antidepressive therapies. Because different studies had contradictory results about the effectiveness of St. John’s Wort compared to placebo and standard antidepressive drugs, a trial was designed to compare both a standard antidepressive therapy (sertraline) and St. John’s Wort to a placebo.

Hypothesis St. John’s Wort is not superior to the placebo or sertraline.

Prospective Study The study followed a group of similar individuals over time who differ with certain factors to determine how these factors affect rates of a certain outcome. double blind study neither the subjects nor the researchers knew which subjects were receiving which treatment

Subjects of the Study 340 patients diagnosed with severe depression randomly assigned based on a written consent form various ages, backgrounds, genders, and socioeconomic statuses

MANIPULATION 116 participants received a placebo treatment 113 participants received St. John’s Wort 111participants received sertraline

RESPONSE The study measured a decrease of depression

Scales of Measurement The Hamilton Depression Scale (HAM-D) Global Assessment of Functioning (GAF) Scale Clinical Global Impressions Scale for Severity (CGI-S)& Improvement (CGI-I), Beck Depression Inventory (BDI)

Results Sertraline was significantly better than the placebo in reducing depression. There was no difference between the St. John’s Wort treatment and the placebo treatment.

In patients diagnosed with major depressive disorder, is St In patients diagnosed with major depressive disorder, is St. John’s Wort a more effective treatment for treating depression compared with a placebo or a standard antidepressive treatment such as sertraline? NO St. John’s Wort did not have stronger effects than a placebo or sertraline on treating depression. St. John’s Wort and placebo have the same effects on treating depression. Sertraline is the most effective for treating depression among the three treatments tested.