Hypericum extract in patients with MDD and reversed vegetative signs

Re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Harald Murck, Maurizio Fava, Jonathan E. Alpert, Andrew A. Nierenberg, David Mischoulon, Michael W. Otto, John Zajecka, Marcus Mannel, Jerrold F. Rosenbaum

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Hypericum extract (HE) might be favourably active in depressed patients with reversed vegetative signs (RVS). Therefore, we performed an exploratory subgroup analysis of a three-armed study to compare HE, fluoxetine, and placebo in patients with major depressive disorder (MDD) in a 12 wk trial. A total of 135 patients were randomized to 12 wk treatment with HE LI 160 (900 mg/d), fluoxetine (20 mg/d), or placebo. Patients with RVS were defined in two steps, according to DSM-IV. First, patients with melancholy-related vegetative signs were excluded. Secondly, patients had to have at least one score of 2 for the items 22-26 of the HAMD-28 scale, which are related to hypersomnia and hyperphagia. Twenty-seven patients remained in the group. Analysis of covariance (ANCOVA) was applied using the HAMD-17 score. Secondly a χ2 test for response was performed, using the same and further an adapted criterium as in recently published studies. ANCOVA revealed a trend to a global difference. Post-hoc analysis showed a trend to superiority of HE compared to placebo and to fluoxetine, but a very large effect size for both differences. Fluoxetine was not different from placebo. The adapted response criterium showed a significant global difference as well as a significant superiority of HE over placebo and over fluoxetine. These data are based on a small sample size and must be considered tentative. A characterization of vegetative features of patients with depression could lead to an overall increased effect size in the treatment with HE.

Original languageEnglish (US)
Pages (from-to)215-221
Number of pages7
JournalInternational Journal of Neuropsychopharmacology
Volume8
Issue number2
DOIs
StatePublished - Jun 2005
Externally publishedYes

Fingerprint

Hypericum
Fluoxetine
Major Depressive Disorder
Placebos
Disorders of Excessive Somnolence
Hyperphagia
Diagnostic and Statistical Manual of Mental Disorders
Sample Size
Depression

Keywords

  • Atypical depression
  • Major depression
  • Reversed vegetative signs
  • St. John's wort

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Hypericum extract in patients with MDD and reversed vegetative signs : Re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo. / Murck, Harald; Fava, Maurizio; Alpert, Jonathan E.; Nierenberg, Andrew A.; Mischoulon, David; Otto, Michael W.; Zajecka, John; Mannel, Marcus; Rosenbaum, Jerrold F.

In: International Journal of Neuropsychopharmacology, Vol. 8, No. 2, 06.2005, p. 215-221.

Research output: Contribution to journalArticle

Murck, Harald ; Fava, Maurizio ; Alpert, Jonathan E. ; Nierenberg, Andrew A. ; Mischoulon, David ; Otto, Michael W. ; Zajecka, John ; Mannel, Marcus ; Rosenbaum, Jerrold F. / Hypericum extract in patients with MDD and reversed vegetative signs : Re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo. In: International Journal of Neuropsychopharmacology. 2005 ; Vol. 8, No. 2. pp. 215-221.
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