Hypericum perforatum (St John's wort) for attention-deficit/hyperactivity disorder in children and adolescents: a randomized controlled trial.

Full Abstract

CONTEXT:
Stimulant medication can effectively treat 60% to 70% of youth with attention-deficit/hyperactivity disorder (ADHD). Yet many parents seek alternative therapies, and Hypericum perforatum (St John's wort) is 1 of the top 3 botanicals used.

OBJECTIVE:
To determine the efficacy and safety of H. perforatum for the treatment of ADHD in children. DESIGN, SETTING,

AND PARTICIPANTS:
Randomized, double-blind, placebo-controlled trial conducted between March 2005 and August 2006 at Bastyr University, Kenmore, Washington, among a volunteer sample of 54 children aged 6 to 17 years who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for ADHD by structured interview.

INTERVENTION:
After a placebo run-in phase of 1 week, participants were randomly assigned to receive 300 mg of H. perforatum standardized to 0.3% hypericin (n = 27) or a matched placebo (n = 27) 3 times daily for 8 weeks. Other medications for ADHD were not allowed during the trial.

MAIN OUTCOME MEASURES:
Performance on the ADHD Rating Scale-IV (range, 0-54) and Clinical Global Impression Improvement Scale (range, 0-7), and adverse events.

RESULTS:
One patient in the placebo group withdrew because of an adverse event. No significant difference was found in the change in ADHD Rating Scale-IV scores from baseline to week 8 between the treatment and placebo groups:
inattentiveness improved 2.6 points (95% confidence interval [CI], -4.6 to -0.6 points) with H. perforatum vs 3.2 points (95% CI, -5.7 to -0.8 points) with placebo (P = .68) and hyperactivity improved 1.8 points (95% CI, -3.7 to 0.1 points) with H. perforatum vs 2.0 points (95% CI, -4.1 to 0.1 points) with placebo (P = .89). There was also no significant difference between the 2 groups in the percentage of participants who met criteria for improvement (score < or = 2) on the Clinical Global Impression Improvement Scale (H. perforatum, 44.4%; 95% CI, 25.5%-64.7% vs placebo, 51.9%; 95% CI, 31.9%-71.3%; P = .59). No difference between groups was found in the number of participants who experienced adverse effects during the study period (H. perforatum, 40.7%; 95% CI, 22.4%-61.2% vs placebo, 44.4%; 95% CI, 25.5%-64.7%; P = .78).

CONCLUSION:
In this study, use of H. perforatum for treatment of ADHD over the course of 8 weeks did not improve symptoms.

TRIAL REGISTRATION:
clinicaltrials.gov Identifier:
NCT00100295.

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Author information

Author/s: Weber, Wendy (W); Vander Stoep, Ann (A); McCarty, Rachelle L (RL); Weiss, Noel S (NS); Biederman, Joseph (J); McClellan, Jon (J);

Affiliation: School of Naturopathic Medicine, Bastyr University, Kenmore, Washington, USA. wendyw(-atsign-)bastyr.edu

Grants: K23AT000929 (Agency:United States NCCAM) ; T32AT00815 (Agency:United States NCCAM)

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural

Journal: JAMA : the journal of the American Medical Association (JAMA), published in United States. (Language: eng)

Reference: 2008-Jun; vol 299 (issue 22) : pp 2633-41

Dates: Created 2008/06/11; Completed 2008/06/16;

PMID: 18544723, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: JAMA. 2008 Jun 11;299(22):2685-6. (PMID: 18544730)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Attention Deficit Disorder with Hyperactivity - drug therapy
Child
Double-Blind Method
Female

Female
Humans
Hypericum
Male
Phytotherapy

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