Sarris Jerome, Kavanagh David J, Deed Gary, Bone Kerry M
School of Medicine, The University of Queensland, Australia.
Hum Psychopharmacol. 2009 Jan;24(1):41-8. doi: 10.1002/hup.994.
We report the first randomised controlled trial (RCT) using a combination of St. John's wort (SJW) and Kava for the treatment of major depressive disorder (MDD) with comorbid anxiety.
Twenty-eight adults with MDD and co-occurring anxiety were recruited for a double-blind RCT. After a placebo run-in of 2 weeks, the trial had a crossover design testing SJW and Kava against placebo over two controlled phases, each of 4 weeks. The primary analyses used intention-to-treat and completer analyses.
On both intention-to-treat (p = 0.047) and completer analyses (p = 0.003), SJW and Kava gave a significantly greater reduction in self-reported depression on the Beck Depression Inventory (BDI-II) over placebo in the first controlled phase. However, in the crossover phase, a replication of those effects in the delayed medication group did not occur. Nor were there significant effects on anxiety or quality of life.
There was some evidence of antidepressant effects using SJW and Kava in a small sample with comorbid anxiety. Possible explanations for the absence of anxiolysis may include a potential interaction with SJW, the presence of depression, or an inadequate dose of Kava.
我们报告了第一项使用圣约翰草（SJW）和卡瓦组合治疗伴有共病焦虑的重度抑郁症（MDD）的随机对照试验（RCT）。
招募了28名患有MDD且伴有焦虑的成年人进行双盲RCT。在进行了2周的安慰剂导入期后，该试验采用交叉设计，在两个对照阶段（每个阶段4周）将SJW和卡瓦与安慰剂进行对比测试。主要分析采用意向性分析和完成者分析。
在意向性分析（p = 0.047）和完成者分析（p = 0.003）中，在第一个对照阶段，与安慰剂相比，SJW和卡瓦在贝克抑郁量表（BDI-II）上自我报告的抑郁症状有显著更大程度的减轻。然而，在交叉阶段，延迟用药组并未重现这些效果。对焦虑或生活质量也没有显著影响。
在一个伴有共病焦虑的小样本中，有一些证据表明使用SJW和卡瓦有抗抑郁作用。未出现抗焦虑作用的可能解释包括与SJW的潜在相互作用、抑郁的存在或卡瓦剂量不足。
