Hypericum perforatum in neuro psychiatric disorders- research updates

    Hypericum perforatum is one of the most commonly researched herb. It has multiple roles in nervous system diseases.Extracts of the Hypericum perforatum plant have been used as herbal remedies for anti-inflammatory, diuretic, and wound-healing properties since the Middle Ages.

   The drug  has been intensively studied on isolated tissue samples, using animal models and through human clinical trials. Recent research shows that extracts of H. perforatum decrease oxidative stress and consequently prevent neurotoxicity, inflammation, and gastrointestinal problems. Flavonoid-rich extracts of H. perforatum (FEHP) are effective against hydrogen peroxide-induced apoptosis in PC12 cells

  In vitro studies have shown that extracts of H.perforatum inhibits serotonin, norepinephrine, and dopamine reuptake by neurons. The drug may be beneficial for premenstrual syndrome, polycystic ovary syndrome, perimenopause and menopause, depression, eczema, and psoriasis.

  A 2008 study found that the flavonols quercetin and kaempferol provide neuroprotective action by decreasing oxidation of the mitochondrial lipid membrane and maintaining mitochondrial transmembrane electric potential [3].

Hypericum perforatum in depression

A randomized controlled clinical trial conducted in Germany of 260 patients with mild to moderate depression showed St. John's wort to be equivalent to standard drug therapy for mild to moderate depression in clinical efficacy [1]

    In Europe, St. John's wort is commonly prescribed supplement for patients having depression. Depression usually occurs due to deficiency of amine neurotransmitters like acetylcholine, norepinephrine, dopamine, and serotonin (5-hydroxytryptamine [5-HT]). Antidepression drugs typically raise the levels of those neurotransmitters.

  The active ingredients in hypericum plant include hypericin and hyperforin which seem to decrease serotonin uptake therefore increasing serotonin levels, and hypericin has been shown to decrease cortisol production.

Clinical trials also demonstrated that the level of therapeutic effect of hypericum plant extract is directly dependent on the concentration of hyperforin

However, a 2017 meta-analysis showed that serotonin-norepinephrine reuptake inhibitors only had a small benefit over placebo and their effect was significantly greater in patients with anxiety disorder than in those with depressive disorder, thus demonstrating that the placebo effect does play a role in the treatment of depression.

References

1.      https://www.sciencedirect.com/topics/medicine-and-dentistry/hypericum-perforatum#:~:text=It%20is%20known%20for%20its,and%20dopamine%20reuptake%20by%20neurons.

2.      https://www.ncbi.nlm.nih.gov/books/NBK92750/

3.      https://pubmed.ncbi.nlm.nih.gov/18522906/