Status:

COMPLETED

St. John's Wort And Kava In The Treatment Of Major Depressive Disorder With Comorbid Anxiety

Lead Sponsor:

The University of Queensland

Conditions:

Depressive Disorder, Major

Anxiety Disorders

Eligibility:

All Genders

18-65 years

Phase:

PHASE2

Brief Summary

SJW has the greatest evidence of herbal medicine efficacy in treating MDD. In treating anxiety, kava has the greatest evidence of efficacy. As comorbidity of MDD and anxiety commonly occurs, it is con...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Any person male or female aged 18-65 presenting with a diagnosis of unipolar depression confirmed by CIDI auto (quantified by BDI) and an anxiety score on the DASS of 8 or above i.e. the mean (quantified also by BAI)
  • Exclusion criteria:
  • Psychotic/ Bipolar illness
  • Current or \< 6 month significant suicidal ideation
  • Diagnosed hepato-biliary disease/inflammation
  • Current or \< 6 month substance abuse disorder including alcohol
  • Current or \< 12 month use of kava, St. John's wort,
  • Current or \< 1 month of synthetic antidepressants or benzodiazepines
  • Previous reaction to kava or St. John's wort
  • Medications that maybe pharmacokinetically altered via St. John's wort including:
  • Amitriptyline anti-coagulants e.g. phenprocoumon, warfarin,
  • Anti-fugals e.g. voriconazole,
  • Anti-histamines e.g. fexofenadine,
  • Benzodiazepines e.g. alprazolam,
  • Chemotherapeutics e.g. irinotecan, digoxin, HIV medication (anti-retrovirals), \* Immunosuppressants e.g. cyclosporine, methadone, OCP,
  • Statins e.g. simvastatin, warfarin (Henderson 2002; Izzo 2004).
  • However this interactions are based on case studies and theoretical interactions and are regarded to be induced by hyperforin (a constituent of St. John's wort); low or non-standardised hyperforin preparations are regarded to not induce drug interactions as little induction of P-glycoprotein and CYP P450 enzymes occurs (Madabushi et al. 2006). Although in vitro studies have confirmed that kava and the isolated kavalactones modulate certain CYP 450 enzymes, no documented evidence of human kava-drug pharmacokinetic interactions exists (Mathews, Etheridge \& Black 2002; Singh 2005)
  • Seeing a psychologist or counsellor currently or in the previous month.
  • Non-English speakers.
  • Pregnancy

Exclusion

    Key Trial Info

    Start Date :

    March 1 2007

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    October 1 2007

    Estimated Enrollment :

    50 Patients enrolled

    Trial Details

    Trial ID

    NCT00451516

    Start Date

    March 1 2007

    End Date

    October 1 2007

    Last Update

    May 19 2008

    Active Locations (1)

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    RBWH

    Brisbane, Queensland, Australia, 4006