A specially manufactured herbal extract of Saint John’s wort is at least as effective in treating moderate-to-severe major depression as paroxetine, according to an article published online February 11th by the British Medical Journal.

German researchers used a randomized, controlled double-blind non-inferiority design to compare the hypericum extract WS 5570 (Saint John’s wort) with paroxetine in 301 men and women (age range, 18-70 years) with moderate-to-severe depression for a six-week period. All participants had baseline scores of 22 or more on the Hamilton depression scale.

At the end of the six weeks, 61 of 122 of those who took St John's Wort found symptoms in decline, whereas only 43 of 122 of patients taking paroxetine reported similar changes.

Participants also suffered more side effects with paroxetine, with 269 adverse effects reported over the treatment period. In contrast, patients taking the herbal extract reported 172 adverse effects, with the most common in both cases being stomach distress.

The authors urge more research on use of the hypericum extract against conventional antidepressants.