Safety of hypericum in patients with depression: A comparison with conventional antidepressants

Conventional antidepressant drugs are associated with a range of adverse drug reactions (ADRs). The herb Hypericum perforatum has been shown to be useful for treating mild to moderate depression and has been associated with few ADRs. In an attempt to systematically compare safety data for hypericum with those of several conventional antidepressants, data were obtained from reports of the clinical trial programmes of the following drugs: dothiepin, fluoxetine, moclobemide and mirtazapine. Although hypericum was associated with fewer and milder ADRs in clinical trials than any of the other drugs, comparisons were difficult because of the different forms in which information was presented. Data from spontaneous reporting schemes and drug monitoring studies have also suggested that ADRs due to hypericum are rare and mild, although there has been one recent report of a possible serious ADR with hypericum. Data on the safety of hypericum in overdose and on interactions with other drugs are as yet scarce.