This while the other group received fluoxetine daily. The

This study is categorized as randomized, controlled,
double-blinded trial. It compared the efficacy of fluoxetine hydrochloride and hypericum
perforatum in the treatment of mild to moderate depression. This trial design
was appropriate to determine the primary objective because it eliminates any
possible biases. The sample size in this study was 70 patients. There were 35
patients in each group. One group received hypericum perforatum daily while the
other group received fluoxetine daily.  The
trial lasted 6 weeks and efficacy was determined using the Hamilton Rating
Scale for Depression (HAMD). The patients were assessed for medication
adherence and had blood tests at week 0, 3, and 6. The primary outcome of the
study was a change in the HAM-D score from baseline. The secondary end points
include changes in the von Zerssen depression scale (DS), Clincial Global
Impression (CGI), and patients’ general evaluation of therapy.

The inclusion criteria were patients aged 18-70 with
mild to moderate depression. The patients also had to score between 16 and 24
on the HAMD. The exclusion criteria were patients that were at risk of suicide,
had other metabolic or psychotic disorders, and patients with liver, thyroid,
parathyroid, kidney, or respiratory insufficiencies. The inclusion and exclusion
criteria were appropriate because it summarizes the majority of the patients
that suffer from depression which could benefit from hypericum perforatum or fluoxetine.

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An advantage to this study is the fact that the
authors used patients with mild to moderate depression as opposed to patients
with severe depression. This is important because there are many aspects in a
person’s life that can affect the severity of their depression. Another advantage
to this study is how the authors used comparable doses of hypericum perforatum to
fluoxetine. The patients in the fluoxetine group received 40 mg daily and the
patients in the hypericum perforatum group received 300 mg daily. A disadvantage
to the study is that the authors obtained clinical laboratory values of the patient’s
heart rate, blood pressure, body weight, and many others but did not include
the data in the results. This data could be useful for assessment of side
effects of the medications. Another disadvantage of this study is that the
duration was only 6 weeks long. Although the patients scored a mean of 10 on
the HAM-D scale (this indicates that treatment for depression is no longer
needed) at the end of the trial, it is still too short to predict long term efficacy
of the drugs. Another disadvantage of the study is that it does not include an
inactive comparator arm utilizing a placebo.

The authors concluded that hypericum perforatum is
therapeutically equivalent to fluoxetine. They also suggest that hypericum
perforatum could be used as an alternative to prescription antidepressants. They
came to this conclusion by comparing the HAM-D scores of the patients from
baseline. The HAM-D scores in each arm of the trial decreased significantly from
start to finish but were not significant when comparing the HAM-D scores
between the groups. Overall, the authors determined that hypericum perforatum has
83% of fluoxetine efficacy. The authors also used the Von Zerssen Depression Scale,
Clinical Global Impression, and patient’s general evaluation of therapy. Patients
in each group of the study reported to be “very satisfied” with treatment at
the end of the 6 weeks. This shows that hypericum perforatum has a place in
therapy for patients with mild to moderate depression.