For the treatment of: Depression ,anxiety.
3 tablet / day with a glass of water .
It is not recommended in sensitive individual to plant materials .
In some patients photodermatitis and allergic symptom is reported .
Other therapeutic Effects :
It may also be of benefit in the treatment of chronic viral infection and , topically , in various skin products .
Pregnancy and Lactation :
It is not recommended .
Each tablet contains 160 mg dried extract of Hypericum perforatum Stand, on 300 g Hypericin .
Hypericum perforatum extracts have shown a wide variety of effects in experimental and clinical studies .
Antidepressant activity: Depression is the result of a deficiency in function of the biogenic amines,eg serotonin ,catecholamine , dopamine ,etc . These neurotransmitters are stored in granules within neurons. After stimulation of the neurons , these neurotransmitters are released into the synaptic cleft via exocytosis .Most antidepressant drugs increase the availability of these amines , particularly serotonin by either inhibiting the reuptake or blocking MAO (1).
In the preliminary studies , it has been shown that the Hypericum extract showed antidepressant activity and its activity was based on the ability of crude hypericin preparations to inhibit both types A and B MAO (2).
Because of this inhibition , there is an increase in the level of neurotransmitters within the brain that maintain normal mood and emotional stability including serotonin , catecholamines , and dopamine (2) .
Later it was found that , flavonoids , also inhibit the MAO enzyme system. (3,4).At least two other mechanisms have been proposed : modulation of interleukin – 6 activity and inhibition of the re- uptake of serotonin . The modulating effect of the extract on interleukin – 6 ( IL – 6 ) is the most interesting as it proposes a mechanism by which Hypericum perforatum interacts with the link between the immune system and mood .The immune system and the nervous system share many common biochemical features and regulatory interaction .In regard to IL – 6 , this cytokine is heavily involved in the communication between cells within and out side the immune system .With regard to the nervous system . IL – 6 in known to modulate hypothalamic pituitary – end organ axes, especially the hypothalamic pituitary-adrenal
( HPA) axis . The hypothesis is that an elevation in IL – 6 results in activation of the HPA axis leading to elevations in CRH and other adrenal regulator hormones , hallmark features in depression .Hypericum perforatum extract has shown an ability to reduce IL – 6 Levels , and hence this action may explain the clinical effectiveness of the extract (5).The study demonstrating reduction of IL – 6 levels involved taking blood samples from five healthy volunteers and four depressive patients (5).A massive suppression of the interleukin – 6 release was found for the extract of Hypericum perfuratum . The hypericum .P. extract has also been shown to exhibit the re – uptake of serotonin similar in fashion to drugs like fluoxetine, paroxetine , and sertraline (6).
In vitro studies have shown that hypericin and pseudohypericin exhibit strong activity against Herpes simplex virus I and II as well as influenza types A and B (7 )..The clinical evaluation of hypericum p extract began with an initial clinical study of six depressed women , aged 55- 65 , Which measured the change in urinary metabolites of noradrenaline and dopamine following administration of a standardized extract of hypericum p extract ( 0.14 hypericin content ) (8) .Researcher found a significant increase in the catecholamine metabolite 3methoxy 4hydroxyphenylglycol a marker commonly used to evaluate the efficacy of the antidepressant therapy .A follow – up study by the same researchers followed 15 women with depression taking the same standardized extract (8)The results demonstrated a significant improvement in symptoms of anxiety , apathy , hypersomnia and insomnia , psychomotor retardation , depression ,and feelings of worthlessness . No side effects were observed .The clincal effectiveness of extract in the treatment of depression has been demonstrated in many well – controlled clinical trials (9) .Also , it has been shown that the hypericum P extract is effective for treatment of seasonal affective disorders (10 ) .The hypericum P extract has been shown to improve sleep quality and well – being in healthy elderly subjects (11) .
1. Goodman and Gilman . The pharmacological basis of therapeutics 2002 .
2. 2-Suzuki o et al ,; Inhibition of monoamine oxidase by hypericin, Planta Medica 1984 .50:272 – 74 .
3. 3-Holzl J .et al . Investigations about antidepressive and mood changing effects of Hypericum perforatum . Planta Med 1989 ; 55 : 643 .
4. 4-Bladt S , Wagner H. Inhibition of MAO by fractions and constituents of Hypericum extract J .Geriatr Psychiatry Neurol 1994 ; 7 : S 57 – 59 .
5. Thiele B , Brink J . Ploch M . Modulation of cytokine expression by Hypericum extract . J . Geriatr Psychiatry Neurol 1994 ; 7 S 60 – 62 .
6. Perovic S , Muller WEG . Pharmacological profile of hypericum extract. Effect of serotonine uptake by postsynaptic receptors.Arzneim Forsch 1987 ; 37 : 10 –13.
7. Lavie D . Antiviral pharmaceutical compositions containing hypericin or pseudohypericin .European Patent Application , No. 87111467.4 – European Patent office Publ No 0256 A2 175 – 177 . 1987
8. Harrer G, Schulz V. Clinical investigation of the anti depressant effectiveness of Hypericum . J. Geriatr Psychiatry Neurol 1994; 7: S 6-8.
9. Hansgren D etal. Multicenter double – blind study examining the anti depressant effectiveness of hypericum extract. J. Geriatr Psychiatry Neurol 1994 ; 7 : S 15 – 18.
10. Martinez B, etal. Hypericum in the treatment of seasonal affective disorders . J. Geriatr Psychiatry Neurol 1994 ; 7 : S 29-33.
11. Schulz H. et al. Effects of Hypericum extract on the sleep EEG in older volunteers . J. Geriatr Psychiatry Neurol 1994 ; 7 : S 39-43.
12. Johnson D et al. Effects of hypericum extract compared with
maprotiline on resting EEG and evoked potentials in 24
volunteers. . J. Geriatr psychiatry Neurol 1994 .