Treatment of depression with St. John's wort extract WS® 5570.: No influence on patients' weight

Drug treatment of depression is frequently associated with weight increase. Such effects have been demonstrated for tricyclics, selective serotonin reuptake inhibitors and other antidepressants. Weight increase has been identified as a major cause of malcompliance which may jeopardize treatment success. In three randomized double-blind trials 900 patients with mild, moderate or severe major depression were treated with 600, 900, 1,200, or 1,800 mg/day St. John's wort extract WS (R) 5570, 20 or 40 mg/day paroxetine, or placebo for six weeks. Responders to acute treatment were offered participation in a 26-week continuation phase with the same treatments. In a reanalysis of the pooled original data we investigated weight changes during antidepressant treatment. Neither patients treated with WS (R) 5570 nor those randomized to placebo showed systematic weight changes during the 32-week period of observation. Marked weight gain or loss were observed only in individual cases. For both drugs average weight change during acute and continuation treatment did not exceed a range of I kg compared to baseline. During the 26-week continuation treatment patients randomized to paroxetine showed an average weight increase of 1.5 kg that was significantly different compared to all dosages of WS (R) 5570 investigated (p <= 0.05). During acute and subsequent continuation treatment of depressive episodes St. John's wort extract WS (R) 5570 does not cause weight changes. The herbal drug thus provides a favorable basis for good treatment compliance.