RCT with St. John's wort in OCD | Compared 30 patients with OCD taking LI 160 extract (range: 300 to 1,800 mg) and 30 patients with OCD taking placebo for 12 weeks16; St. John's wort had no effect on reducing Yale-Brown Obsessive-Compulsive Scale total or subscale scores | Agitation side effect more common with St. John's wort |
Open, uncontrolled study of St. John's wort in OCD | Significant reductions in the Yale-Brown Obsessive-Compulsive Scale score in 12 patients with OCD starting one week into the study and continuing throughout the 12-week trial17; the compound used was a 450-mg, extended-release formulation of 0.3% Hypericum taken two times a week | The small number of patients and lack of comparison to placebo make this evidence weak; few side effects reported |
RCT with St. John's wort in social phobias | Compared flexible doses of LI 160 extract (range: 300 to 1,800 mg twice a day) and placebo in 40 patients with social phobias18; St. John's wort had no effect in reducing anxiety scores | Side effects no worse than placebo |
RCT with St. John's wort in somatoform disorders | St. John's wort was used to treat somatoform disorders using reductions in the Hamilton Anxiety Scale somatic anxiety subscale score as the primary outcome measure19; after patients with significant depressive symptoms were excluded, 150 patients were randomized to St. John's wort or placebo; dosage of the LI 160 extract was 300 mg twice a day | Somatoform disorders have complex relationship with anxiety disorders |
Results showed a strong positive effect of St. John's wort, compared with placebo, in reducing somatic anxiety, psychic anxiety, overall anxiety scores, and physician and patient ratings of somatoform disorder symptoms |
Open trial with St. John's wort plus valerian in anxiety and depression | Valerian was used in combination with St. John's wort to treat patients with comorbid anxiety and depression; the combination was better than St. John's wort alone at reducing anxiety scores20 | Suggestive improvement of St. John's wort with addition of valerian; very few side effects |
RCT with valerian versus diazepam (Valium) and placebo in GAD | Randomized, double-blind, placebo-controlled comparison of valerian with diazepam in GAD, 12 patients per group for four weeks21; no differences between valerian and placebo, or between diazepam and placebo | Too underpowered to demonstrate differences in effectiveness; no differences in side effects |
RCT with Sympathyl versus placebo; two tablets twice a day in GAD | Double-blind randomized trial conducted among patients with mild to moderate GAD in 22 general practices in Paris, France22; Sympathyl (n = 130) and placebo (n = 134) groups were relatively large; after three months the Sympathyl group showed a 10.6-point decline in the Hamilton Anxiety Scale score, whereas the placebo group showed an 8.9-point decline | Statistically significant advantage for Sympathyl compared with placebo, but size of difference (1.7 scale points) very small |
RCT of passionflower versus oxazepam (Serax; brand no longer available in the United States) in GAD | Each group had 18 patients with GAD23; both groups started with mean Hamilton Anxiety Scale scores of 20 and ended with significant reductions to 6; the groups also had the same level of side effects | Both groups equally positive but small study with no placebo group; results unclear |