From: Systematic reviews of complementary therapies – an annotated bibliography. Part 2: Herbal medicine
Features | |||||||
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Author | Indication | Intervention | Comparisons | Studies | 1/2/3/ | Results | Author's Conclusion |
Year | 4/5 | ||||||
St John's wort ( Hypericum perforatum ) | |||||||
Gaster | depression | hypericum | placebo and | 8 RCT | p/y/p/ | 4 placebo-controlled trials with | Data suggest that hypericum is |
2000 [20] | antidepressants | y/n | positive results, in 4 trials | superior to placebo, insuffcient | |||
standard antidepr. tended to be | evidence re equivalence with | ||||||
slightly better | antidepressants | ||||||
Williams | depression | hypericum | placebo and | 14 RCT | y/y/n/ | Treatment response: RR 1.9 | Data suggest that hypericum is |
2000 & | (and other | antidepressants | y/y | (95%C11.2–2.8) vs. placebo and | superior to placebo, insuffcient | ||
Mulrow 98 | drugs) | 1.2 (1.0–1.4) vs. antidepressants | evidence re equivalence with | ||||
antidepressants | |||||||
Kim 99 [23] | depression | hypericum | placebo and | 6 RCT | p/y/y/ | Treatment response: RR 1.48 | Hypericum more effective than |
antidepressants | y/y | (95%C11.03–1.92) vs. placebo | placebo and similarly effective as | ||||
and 0.98 (0.67–1.28) vs. | low dose antidepressants; quality | ||||||
antidepressants | problems | ||||||
Stevinson | depression | hypericum | placebo and | 6 RCT | y/y/y/ | Only trials published after Linde | Data confirm findings of earlier |
99 [24] | antidepressants | y/n | 96; trials show effects better | trials, but still insuff. evidence to | |||
than placebo/similar to | assess equivalence with | ||||||
antidepressants | antidepressants | ||||||
Linde 98 & | depression | hypericum | placebo and | 27 RCT | y/y/y/ | Treatment response: RR 2.47 | Hypericum more effective than |
antidepressants | y/y | (95%C11.69–3.61) vs. placebo | placebo. Inadequate evidence to | ||||
and 1.01 (0.87–1.16) vs. | assess equivalence with | ||||||
antidepressants | antidepressants | ||||||
Volz 97 | depression | hypericum | placebo and | 15 | p/p/n/ | Most placebo-controlled trials | A therapy with hypericum of mild |
[27] | antidepressants | RCT/CCT | n/n | positive; similarly effective as | and moderate depression can be | ||
(not adequately dosed) | attempted. Further studies needed | ||||||
antidepressants | |||||||
Ernst 95 | depression | hypericum | placebo and | 11 RCT | y/y/y/ | Most of 8 placebo-controlled | Hypericum is superior to placebo |
[28] | antidepressants | y/n | trials positive. 3 trials against | and seems equally effective as | |||
standard medication with similar | standard medication | ||||||
effects | |||||||
Volz 2000 | mild to | hypericum | fluoxetine | 17+9 | n/y/n/ | No direct comparison of | Response rates are similar; |
[29] | mod. | CCT | y/n | hypericum and fluoxetine | findings difficult to interpret | ||
depression | available. Mean depression | because of the indirect comparison | |||||
score (HAMD) reduction in | |||||||
hypericum trials 53%, in | |||||||
fluoxetine trials 55% | |||||||
Friede 98 | anxiety in | hypericum | placebo, | 8 RCT | ?/y/y/ | Trials collectively show reduction | Hypericum is effective for |
[30] | depressed | amitriptyline | y/n | of anxiety symptoms over | depressed patients with anxiety | ||
p. | placebo. Only 1 trial vs | ||||||
amitriptyline | |||||||
Garlic ( Allium sativum ) | |||||||
Lawrence | cardiovasc. | garlic | mainly placebo; | 45 RCT | y/y/y/ | 37 trials consistently show small | Insufficient data to draw conclusion |
2000 [31] | risk factors | no & other | y/y | short-term effects over placebo | regarding clinical cardiovascular | ||
treatment | for cholesterol reduction. No | outcomes. Garlic preparations may | |||||
consistent effects on blood | have small, positive, short-term | ||||||
pressure, promising effects re | effects on lipids | ||||||
platelet aggregation and | |||||||
fibrionolytic activity | |||||||
Stevinson | hyperchol- | garlic | placebo | 13 RCT | y/y/y/ | Pooled total cholesterol | Available data suggest that garlic is |
2000 [32] | esterolemia | y/y | reduction over placebo 0.41 | superior to placebo. The size of the | |||
(95% Cl -0.66 to -0.15) mmol/l; | effect is modest. The use of garlic | ||||||
when analysis restricted to high | for hyperchol. is therefore of | ||||||
quality trials 0.11 (-0.30 to 0.08) | questionable value | ||||||
Silagy 94 & | cholesterol | garlic | placebo | 16 RCT | y/p/y/ | Pooled cholesterol reduction | Meta-analysis suggests positive |
Neil 96 | lowering | y/y | over placebo 0.65 (95% Cl 0.53– | effects but reviewers are sceptic | |||
0.76) mmol/l | (low quality; own replication | ||||||
negative) | |||||||
Warshafsky | cholesterol | garlic | placebo | 5 RCT | p/y/y/ | Pooled cholesterol reduction | Available evidence supports the |
93 [35] | lowering | y/y | over placebo 0.59 (95%Cl 0.44– | use of garlic as one modality to | |||
0.74) mmol/l | decrease cholesterol levels | ||||||
Silagy 94 | lowering | dried garlic | placebo, other | 8 RCT | y/p/y/ | Pooled reduction over placebo: | Garlic maybe of some clinical use |
[36] | blood | (Kwai) | treatment | y/y | SBP 7.7 (95% Cl 4.3–11.0), DBP | in subjects with mild hypertension. | |
press. | 5.0 (2.9–7.1) mm Hg | Further research needed | |||||
Kleijnen 91 | cardiovasc. | garlic | placebo | 18 | p/p/y/ | Most studies with shortcomings. | No clear conclusion drawn |
[37] | risk factors | supplements | RCT/CCT | y/n | The majority of trials with pos. | ||
results but inconsistent effect | |||||||
sizes | |||||||
Kleijnen 89 | cardiovasc. | garlic & | unclear | 10 RCT, | y/p/n/ | All trials with severe | Inadequate evidence to justify |
[38] | risk factors | onions | 8 CCT | y/n | shortcomings. Fresh garlic with | supplementation, further research | |
beneficial effcts, onions and | needed | ||||||
commercially available | |||||||
supplements yielded | |||||||
contradictory results | |||||||
Jepson 97 | lower limb | garlic | placebo | 1 RCT | y/y/y/ | Walking distance not | Insufficient evidence |
[39] | atheroscler. | y/- | significantly different between | ||||
groups |