Objectives:

Review the evidence regarding the effectiveness, tolerability, and safety of hypericum in the treatment of depressive disorder (DD).

Data sources:

NICE, Canadian Medical Association Infobase, PubMed - Clinical Queries, The Cochrane Library, BMJ, Bandolier, and DARE - Centre for Reviews and Dissemination.

Methods:

The research for scientific articles was performed on online Evidence-Based Medicine platforms, with the keywords ‘Hypericum’ and ‘Depressive Disorder’. Articles were selected based on title, year of publication, and abstract.

Results:

Two clinical guidelines (CG), three meta-analyses (MA), two systematic reviews (SR), and one original article (OA) were included in this review. One CG reported that hypericum can be used as first-line in mild to moderate major DD and as an adjuvant treatment of second-line in moderate to severe major DD. Another CG does not support the use. All of MA and SR conclude that hypericum is more effective than placebo in the treatment of DD, with two MA and two SR added that there is no increase of adverse effects. The two SR mentioned the risk of interactions with other drugs. The OA also affirms the effectiveness of hypericum in postmenopausal women.

Conclusion:

There is evidence regarding the efficacy of hypericum in mild to moderate DD. The available data appears to be consistent with its good tolerability, but also in terms of the risk of interactions with other drugs. The limitations of the recommendation are essentially due to the mechanisms of action that are not fully understood.

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