Department of General Practice, The University of Melbourne, Carlton, Vic., Australia.
J Pharm Pharmacol. 2019 Jan;71(1):117-128. doi: 10.1111/jphp.12775. Epub 2017 Jun 27.
Extracts of Hypericum perforatum, more commonly known as St John's wort (SJW), have good evidence for treating depression. The herb is easily accessible and widely used by consumers, although it has potential for interaction with other medicines. Consumers' use of SJW is often not discussed with their general practitioners (GPs). It is unclear how GPs perceive use of SJW in practice and the implications for consumers and pharmacists.
Explore GPs' perception of SJW use in practice.
Scoping review.
Few studies explore GPs' perceptions of SJW for depression, but they appear to recommend it infrequently, except in Germany. Reasons for limited use in practice include lack of knowledge, particularly regarding which preparations and dosages have trial evidence, and lack of standardisation of active ingredients. Guidelines either do not mention SJW or advise against its use.
Consumers drive SJW use but often do not disclose to their GPs, which is concerning due to issues about safety. Pharmacists could play an important role here. Improved education about SJW is required for both GPs and consumers, including the need for communication between them and their pharmacists. Lack of adoption of evidence-based therapy for depression should be explored further.
贯叶金丝桃提取物，通常被称为贯叶连翘（SJW），有很好的证据可以治疗抑郁症。这种草药很容易获得，被消费者广泛使用，尽管它有可能与其他药物相互作用。消费者使用 SJW 通常不会与他们的全科医生（GP）讨论。目前尚不清楚全科医生在实践中如何看待 SJW 的使用，以及这对消费者和药剂师意味着什么。
探讨全科医生对 SJW 在实践中的使用的看法。
范围综述。
很少有研究探讨全科医生对 SJW 治疗抑郁症的看法，但他们似乎很少推荐使用 SJW，除了在德国。在实践中使用受限的原因包括缺乏知识，特别是关于哪些制剂和剂量有试验证据，以及缺乏活性成分的标准化。指南要么没有提到 SJW，要么建议不要使用 SJW。
消费者推动了 SJW 的使用，但通常不会向他们的全科医生透露，这令人担忧，因为存在安全性问题。药剂师可以在这里发挥重要作用。需要对全科医生和消费者进行关于 SJW 的教育，包括他们与药剂师之间进行沟通的必要性。应进一步探讨缺乏采用基于证据的抑郁症治疗方法的问题。
