Tanya Vapnik

St John's wort versus placebo in obsessive–compulsive disorder: results from a double-blind study

Although St Johns wort (Hypericum perforatum) is one of the most widely used and studied herbal medicines for depression, less is known about its efficacy in anxiety disorders, in spite of the fact that patients with anxiety disorders are among the most likely to self-medicate using alternative treatments. Pharmacokinetic evidence for the serotonergic, domaminergic and GABAminergic activity of hypericum, and a recent successful open-label study, suggests that it may be effective for obsessive–compulsive disorder (OCD). Sixty subjects were randomized to 12 weeks of treatment with St Johns wort (LI 160) or matching placebo. Subjects with Hamilton Depression Scale scores of 16 or above were excluded. A flexible-dose schedule was utilized (600–1800 mg/day). The mean change on the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) with St Johns wort (3.43) was not significantly different than the mean change found with placebo (3.60) (P=899). No significant differences were found on any of the Y-BOCS subscales. The percentage of patients rated as ‘much’ or ‘very much’ improved at endpoint was not significantly different between St Johns wort (17.9%) and placebo (16.7%) (P=0.905). Only one patient from each group discontinued due to adverse events [sinus infection (St Johns wort); confusion (placebo)]. The results fail to support the efficacy of St Johns wort for OCD.

Ambulatory monitoring of panic patients during regular activity: A preliminary report

Ten patients with panic disorder and 10 matched control subjects were compared as to their blood pressure and heart rate during regular daily activity. Physiological responses were monitored by ambulatory recorder, and subjective reports of mood were collected. Data were analyzed controlling for activity and stress level of the subjects. Diastolic blood pressure emerged as a possible discriminatory factor between the groups. A trend for higher heart rate occurred in the panic group. In behavioral terms, panic patients tended to avoid anxiety-provoking situations, resulting in anxiety ratings comparable to those of the control group. Thus, recorded physiological differences between the groups may reflect heightened baseline autonomic activity in panic patients.