1. PICO
Amanda DiMaria

2. 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?

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




4. 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

5. 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

6. 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.

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

8. 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

9. 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

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

11. RESPONSE
The study measured a decrease of depression

12. 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)

13. 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.

14. 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.