PHAR 460 Lecture Notes - Lecture 6: Hypericin, Phototoxicity, Hyperforin
4 Oct 2016
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Main active ingredient: hyperforin (past studies used hypericin though) Some evidence of inhibition of reuptake of serotonin, noradrenaline and/or dopamine. Small benefit on symptoms not clinically significant. Oral dosing some positive evidence but unclear. Epa+dha could be useful as an adjunct (conflicting) Some limitations varied quality of products, standardization, doses, severity of depression, other therapy, antidepressant doses were on the low side. Better quality studies and more severe depression found smaller benefit. Very low quality variable results on sx and remission. High variability and low quality: adjunctive drugs, comorbidities, varied interventions/doses, poor concealment, publication bias, small and short studies. Low quality: small and short studies, varied efficacy, mostly iv/im studies done, mainly compared with tcas. Better quality study showed no to little benefit. Adr: common: headache, fatigue, gi upset, insomnia (take early in the day). Di: many drug interactions: antiretrovirals, chemo drugs, digoxin, immunosuppressants, opiates, ocs, warfarin, antidepressants, ccbs, statins, theophylline, serotoninergic drugs.
