Findling Robert L, McNamara Nora K, O'Riordan Mary Ann, Reed Michael D, Demeter Christine A, Branicky Lisa A, Blumer Jeffrey L
Department of Psychiatry, Case Western Reserve University/University Hospitals of Cleveland, USA.
J Am Acad Child Adolesc Psychiatry. 2003 Aug;42(8):908-14. doi: 10.1097/01.CHI.0000046900.27264.2A.
This pilot study examined the effectiveness, safety, tolerability, and pharmacodynamics of Hypericum perforatum (St. John's wort) in the treatment of youths diagnosed with major depressive disorder.
Youths 6 to 16 years of age meeting DSM-IV criteria for major depressive disorder with depressive symptoms of at least moderate severity were eligible to enroll between January 1999 and January 2001 in this 8-week, prospective, open-label, outpatient study. Outcome measures included the Children's Depression Rating Scale-Revised (CDRS-R) and the Clinical Global Impressions (CGI) scale. A priori criteria for response consisted of a CDRS-R score of </=28 and a CGI severity score </=2. Patients were initially prescribed 150 mg St. John's wort three times daily. If at the end of week 4 the patient did not meet a priori response criteria, the dose was increased to 300 mg three times daily.
Thirty-three youths with a mean (SD) age of 10.5 (2.9) years were enrolled. After 4 weeks of St. John's wort therapy, 22 youths had their dose increased to 900 mg/day. Twenty-five of the patients met response criteria after 8 weeks of treatment. Overall, St. John's wort was well tolerated.
St. John's wort may be an effective treatment for youths diagnosed with major depressive disorder. Placebo controlled trials seem indicated.
本初步研究考察了贯叶连翘（圣约翰草）治疗诊断为重度抑郁症的青少年的有效性、安全性、耐受性及药效学。
1999年1月至2001年1月期间，年龄在6至16岁、符合DSM-IV标准的重度抑郁症且抑郁症状至少为中度严重程度的青少年有资格参加这项为期8周的前瞻性、开放标签的门诊研究。疗效指标包括儿童抑郁评定量表修订版（CDRS-R）和临床总体印象（CGI）量表。反应的先验标准包括CDRS-R评分≤28分和CGI严重程度评分≤2分。患者最初每日三次服用150毫克圣约翰草。如果在第4周结束时患者未达到先验反应标准，则剂量增加至每日三次300毫克。
招募了33名平均（标准差）年龄为10.5（2.9）岁的青少年。圣约翰草治疗4周后，22名青少年的剂量增加至900毫克/天。25名患者在治疗8周后达到反应标准。总体而言，圣约翰草耐受性良好。
圣约翰草可能是治疗诊断为重度抑郁症青少年的有效疗法。似乎需要进行安慰剂对照试验。
