Role in depression of a multi-fractionated versus a conventional Hypericum perforatum extract

BACKGROUND: Hypericum perforatum is used as medicinal plant for mild to moderately severe depression. Several trials have found hypericum to be more effective than placebo or some antidepressant drugs, but the exact mechanism and most relevant compounds are still unclear. A possible hypothesis is that the antidepressant activity might be due to its multiplicity of bioactive compounds. Aim is to test if greater chemical complexity could result in a greater hypericum antidepressant action. METHODS: A retrospective, 12-month, open-label, observational, controlled trial was conducted to compare the antidepressant clinical activity of a conventional Hypericum perforatum (C-Hp) versus a multi-fractionated (M-Hp) one (IperiPlex (R)). RESULTS: Treatment with C-Hp demonstrated no efficacy after 6 months and partial (P<0.05) efficacy after 12 months. Treatment with MF-Hp demonstrated highly (P<0.01) significant results at both 6 and 12 months. Analysis of the monthly reduction coefficient demonstrated that treatment with MF-Hp was twice as effective as treatment with C-Hp (0.96 versus 0.48). No side effects were reported. CONCLUSIONS: A multi-fractionated hypericum extract has better clinical outcomes in subjects with depression without determining an increased risk of toxicity or reduced tolerability.