Hyperici herbae extractum siccum

ATC code: N06AX25 Pharmacotherapeutic group: Other antidepressants, St. John's wort Dry extract of St. John's wort inhibits synaptosomal reuptake of the neurotransmitters noradrenaline, serotonin and dopamine. Subchronic administration produces down-regulation of beta-adrenergic receptors; this alters the behaviour of laboratory animals in certain antidepressant models (e.g. the forced swim test) in a manner comparable to synthetic antidepressants. The activity is attributed to naphthodianthrones such as hypericin and pseudohypericin, phloroglucinol derivatives such as hyperforin, and flavonoids. Clinical efficacy and safety In controlled, double-blind and open-label trials versus placebo, symptoms of psychovegetative disorder, mood lability, low mood, nervous restlessness and anxiety showed significant improvement compared with placebo. Compared with various synthetic antidepressants such as amitriptyline, imipramine or maprotiline, as well as benzodiazepines such as bromazepam, St. John's wort extract demonstrated comparable efficacy with a substantially lower incidence of adverse reactions.