hypericum and Mental-Disorders

St. John's wort (Hypericum perforatum) has been extensively studied and reviewed for its use in depression; however, there is less salient discussion on its clinical application for a range of other psychiatric disorders. This article outlines the current evidence of the efficacy of St John's wort in common psychiatric disorders, including major depression, bipolar depression, attention-deficit hyperactivity disorder, obsessive-compulsive disorder, social phobia, and somatization disorder. Mechanisms of action, including emerging pharmacogenetic data, safety, and clinical considerations are also detailed.

Topics: Clinical Trials as Topic; Herb-Drug Interactions; Humans; Hypericum; Mental Disorders; Phytotherapy; Plant Extracts

An increasing number of studies have evaluated the role of herbal supplements in pediatric disorders, but they have numerous limitations. This review provides an overview of herbal components, regulation of supplements, and importance of product quality assurance. Use of herbal supplements is discussed with reference to factors that influence use in the pediatric population. The remainder of the article discusses the use of St John's wort, melatonin, kava, valerian, eicosapentaenoic acid, and docosahexaenoic acid, focusing on indications, adverse effects, and drug interactions, and providing a limited efficacy review. Herbal supplements used for weight loss are also briefly discussed.

Topics: Adolescent; Child; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Herb-Drug Interactions; Herbal Medicine; Humans; Hypericum; Kava; Melatonin; Mental Disorders; Phytotherapy; Plant Preparations; Valerian

To examine recent empirical studies of herbal and dietary treatments for psychiatric disorders in children and adolescents.. Very few quality studies into the use of omega-3 fatty acids, St John's wort, dietary manipulations, kava, gingko and lemon balm in managing psychiatric disorders have been conducted in children and adolescents.. A number of herbal treatments show promise, but much more empirical research is required to establish their efficacy in the paediatric population.

Topics: Adolescent; Child; Complementary Therapies; Dietary Supplements; Fatty Acids, Omega-3; Humans; Hypericum; Mental Disorders; Phytotherapy; Plant Preparations

Herbal drug treatment has been known for centuries as a part of traditional medicine. Nowadays, it is still considered a useful and natural way to treat several medical conditions, including mental disturbances. The most frequently treated mental conditions include mood disorders (mainly depression), anxiety disorders, somatoform disorders, age-related cognitive decline, and sometimes psychotic disorders. Some herbal formulations, such as St. John's wort, have been analyzed in clinical trials to estimate their real value. The use of other herbal medicines, such as Kava-kava, valerian, and Ginkgo biloba is discussed.

Topics: Clinical Trials as Topic; Ginkgo biloba; Herbal Medicine; Humans; Hypericum; Kava; Mental Disorders; Phytotherapy; Plant Preparations; Valerian

The use of alternative medicines is increasing world-wide and in Israel. These drugs, considered by the Ministry of Health as food supplements, are to be obtained at pharmacies and health stores and are being sold freely, without any professional advice. Many of the herbs are used by patients to treat psychiatric disorders. These herbs have a pharmacological activity, adverse effects and interactions with conventional drugs, which can produce changes in mood, cognition, and behavior. We present the most commonly used herbal drugs, and discuss their safety and efficacy in psychiatric practice. Hypericum--used as an antidepressant and as an antiviral medicine, was reported in 23 randomized clinical trials reviewed from the MEDLINE. It was found to be significantly more effective than placebo and had a similar level of effectiveness as standard antidepressants. Recent studies almost clearly prove that this herb, like most of the conventional antidepressants, can induce mania. Valerian--is used as an anti-anxiety drug, and reported to have sedative as well as antidepressant properties. In contrast to the significant improvement in sleep that was found with the use of valerian, compared to placebo, there are several reports on the valerian root toxicity. This includes nephrotoxicity, headaches, chest tightness, mydriasis, abdominal pain, and tremor of the hands and feet. Ginseng--another plant that is widely used as an aphrodisiac and a stimulant. It has been associated with the occurrence of vaginal bleeding, mastalgia, mental status changes and Stevens-Johnson syndrome after it's chronic administration. It has interactions with digoxin, phenelzine and warfarin. Ginkgo--in clinical trials the ginkgo extract has shown a significant improvement in symptoms such as memory loss, difficulties in concentration, fatigue, anxiety, and depressed mood. Long-term use has been associated with increased bleeding time and spontaneous hemorrhage. Ginkgo should be used cautiously in patients receiving aspirin, NSAIDs, anticoagulants or other platelet inhibitors. Health care professionals can no longer ignore the widespread use of alternative medicines and cannot continue with the "don't ask, don't tell" policy. Clinicians should ask the patients about their use of herbs in a non-judgmental way, and should document the patient's use of these drugs. Finally, we must be more aware of the side effects and the potential drug interactions of these herbs, and advise our patients to

Topics: Ginkgo biloba; Humans; Hypericum; Mental Disorders; Panax; Phytotherapy; Plants, Medicinal; Psychiatry; Safety; Valerian

Many unregulated over-the-counter agents for the treatment of depression are now available to patients and consumers. The potential for adverse neuropsychiatric effects with these agents has not been systematically studied in most cases.. The author performed a MEDLINE search on a variety of herbal and nonherbal over-the-counter agents said to be useful in the treatment of depression. The Physicians' Desk Reference for Herbal Medicines was also consulted.. Although many of the herbal agents said to have benefits in depression appear to be safe, serious neuropsychiatric side effects and interactions have been reported for several over-the-counter "antidepressants." There is reason to suspect underreporting of those adverse events. Moreover, there is very little evidence from systematic studies regarding the potential for drug-drug or herb-drug interactions with these over-the-counter agents. Vitamins and amino acids touted for the treatment of depression are also not without risk.. Although some over-the-counter remedies for depression are probably safe and effective for as-yet unidentified subgroups of depressed individuals, more research is required before these agents can be recommended for routine use. Stricter U.S. Food and Drug Administration oversight of these agents is indicated.

Topics: Adverse Drug Reaction Reporting Systems; Antidepressive Agents; Dehydroepiandrosterone; Depressive Disorder; Drug Information Services; Drug Interactions; Humans; Hypericum; Inositol; Mental Disorders; Nonprescription Drugs; Phytotherapy; Plants, Medicinal; Psychoses, Substance-Induced; S-Adenosylmethionine

There are a number of compounds that can modify the activity of ABC (ATP-binding cassette) and SLC (solute carrier) transporters in the blood-brain barrier (BBB). The aim of this study was to investigate the effect of natural and synthetic substances on the expression level of genes encoding transporters present in the BBB (mdr1a, mdr1b, mrp1, mrp2, oatp1a4, oatp1a5 and oatp1c1). Our results showed that verapamil caused the greatest reduction in the mRNA level while other synthetic (piracetam, phenobarbital) and natural (codeine, cyclosporine A, quercetin) substances showed a selective inhibitory effect. Further, the extract from the roots of Panax ginseng C. A. Meyer exhibited a decrease of transcription against selected transporters whereas the extract from Ginkgo biloba L. leaves resulted in an increase of the expression level of tested genes, except for mrp2. Extract from the aerial parts of Hypericum perforatum L. was the only one to cause an increased mRNA level for mdr1 and oatp1c1. These findings suggest that herbs can play an important role in overcoming the BBB and multidrug resistance to pharmacotherapy of brain cancer and mental disorders, based on the activity of selected drug-metabolizing enzymes and transporters located in the BBB.

Topics: Animals; Biological Transport; Blood-Brain Barrier; Brain; Brain Neoplasms; Ginkgo biloba; Hypericum; Male; Membrane Transport Proteins; Mental Disorders; Panax; Plant Extracts; Plant Leaves; Plant Roots; Plants, Medicinal; Rats; Rats, Wistar; Transcription, Genetic; Verapamil

Herbal medicine is widely used by individuals with mental health problems, although research on their health characteristics and health care utilization patterns—including concomitant treatment with conventional mental health care and psychotropic medication—remains limited.. We gathered data from the National Comorbidity Survey Replication (NCS-R), a representative survey of US adults in which diagnoses of mental disorders were based on a fully structured diagnostic interview.. Our analysis found that NCS-R respondents with mental disorders were significantly more likely to have used herbal medicines for mental health problems than respondents who did not meet criteria for a mental disorder. Users of herbal medicines for mental health problems were likely to utilize conventional health care as well, particularly conventional psychiatric medication. Herbal use also was associated with having multiple comorbid medical problems.. A substantial proportion of US adults use herbal medicine to treat mental health problems. Herbal medicine is frequently used concomitantly with conventional health care, including prescription psychotropic medication. Herbal use also is associated with having multiple chronic medical problems. These factors increase the potential for interactions between herbal medicines and psychiatric and nonpsychiatric medications.

Topics: Adult; Alcohol Drinking; Comorbidity; Complementary Therapies; Drug Therapy, Combination; Drug Utilization; Female; Health Surveys; Humans; Hypericum; Male; Mental Disorders; Mental Health Services; Middle Aged; Phytotherapy; Psychotropic Drugs; Substance-Related Disorders; United States; Utilization Review

Topics: Complementary Therapies; Dietary Supplements; Fatty Acids, Omega-3; Folic Acid; Ginkgo biloba; Humans; Hypericum; Melatonin; Mental Disorders; Mental Health; S-Adenosylmethionine; Valerian

Despite its poorly described pharmacology, effectiveness, and safety, use of St. John's wort (SJW) is largely unsupervised and unexplored, and can potentially lead to adverse outcomes. We conducted a telephone survey of 43 subjects who had taken SJW to assess demographics, psychiatric and medical conditions, dosage, duration of use, reason for use, side effects, concomitant drugs, professional consultation, effectiveness, relapse, and withdrawal effects. Most subjects reported taking SJW for depression, and 74% did not seek medical advice. Mean dosage was 475.6+/-360 mg/day (range 300-1200 mg/day) and mean duration of therapy was 7.3+/-10.1 weeks (range 1 day-5 yrs). Among 36 (84%) reporting improvement, 18 (50%) had a psychiatric diagnosis. Twenty (47%) reported side effects, resulting in discontinuation in five (12%) and one emergency room visit. Two consumers experienced symptoms of serotonin syndrome and three reported food-drug interactions. Thirteen consumers experienced withdrawal symptoms and two had a depressive relapse. These data suggest the need for greater consumer and provider awareness of the potential risks of SJW in self-care of depression and related syndromes.

Topics: Adult; Aged; Data Collection; Depression; Drug Interactions; Female; Humans; Hypericum; Male; Mental Disorders; Middle Aged; Phytotherapy; Plants, Medicinal; Retrospective Studies; Self Medication

Topics: Antidepressive Agents; Attitude to Health; Australia; Humans; Hypericum; Mental Disorders; Phytotherapy; Plants, Medicinal; Psychiatry

Herbal remedies are commonly used for psychiatric problems, but there is virtually no data about the use of these substances by young persons or by patients in treatment. Four adolescents who used St. John's Wort while under psychiatric care are described. Three of the patients had been reluctant to reveal this to their psychiatrist, believing the doctor had no interest in alternative medicine or would disapprove. Patient beliefs that prescribed medication has limitations and that natural products are safe contributed to the use of herbal remedies. The cases raise a number of issues, including the need for clinicians to routinely ask patients about alternative medicine use, to learn more about these treatments, and to discuss these approaches objectively with patients.

Topics: Adolescent; Female; Humans; Hypericum; Male; Mental Disorders; Phytotherapy; Plants, Medicinal