St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study.
St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study.
复制标题
圣约翰草与安慰剂治疗社交恐惧症：安慰剂对照试点研究的结果。
DOI：
10.1097/01.jcp.0000150227.61501.00
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发表时间：
2005
影响因子：
2.9
通讯作者：
Futterer,Rise
中科院分区：
文献类型：
--
作者：
Kobak,KennethA;Taylor,LeslieVH;Warner,Gemma;Futterer,Rise
认识到社交焦虑症（社交恐惧症）是一种常见的致残性疾病，导致其药物治疗取得了新的进展。选择性血清素再摄取抑制剂（副作用）和行为疗法（缺乏训练有素的治疗师）的局限性，加上该疾病患者倾向于采用替代疗法进行自我治疗，导致人们对圣约翰草（SJW）（贯叶连翘）治疗这种疾病的兴趣。尽管文献褒贬不一，但 SJW 已在多项双盲抑郁症试验和一些焦虑症开放标签研究中证明了疗效。有药代动力学证据表明金丝桃具有血清素能、多胺能和 GABA 胺能活性，所有这些都与社交焦虑症有关。本研究旨在生成试点数据，以检验 SJW 对广泛性社交焦虑症的潜在功效。 40 名受试者被随机接受为期 12 周的灵活剂量 (600-1800 mg) SJW (n= 20) 或安慰剂 (n= 20) 治疗。患有共病抑郁症的受试者（临床医生 HAMD > 16）被排除在外。结果发现，SJW 的 Liebowitz 社交焦虑量表平均变化 (11.4) 和安慰剂 (13.2) 之间没有显着差异，P= 0.27，效应大小=− 0.09。事后分析发现，较大的效应量与基线严重程度增加相关，忽略了第一周内评分可变 (±30%) 的患者，并使用自我报告的 HAMD 评分进行排除。该研究结果未能为 SJW 对社交恐惧症的疗效提供证据。方法改进对信号检测的影响虽然暗示了改进，但仍有待确定。
Recognition of social anxiety disorder (social phobia) as a common and disabling condition has led to new advances in its pharmacotherapy. Limitations with selective seroton reuptake inhibitors (side effects) and behavior therapy (scarcity of trained therapists), coupled with the tendency for patients with the disorder to self-medicate with alternative treatments, have led to the interest in Saint John's wort (SJW)(Hypericum perforatum) for this disorder. Although the literature is mixed, SJW has demonstrated efficacy in several double-blind depression trials, and some open-label studies with anxiety disorders. There is pharmacokinetic evidence for the serotonergic, domaminergic, and GABAminergic activity of hypericum, all of which are implicated in social anxiety disorder. This study was designed to generate pilot data to examine the potential efficacy of SJW in generalized social anxiety disorder. Forty subjects were randomized to 12 weeks of treatment with a flexible dose (600-1800 mg) of SJW (n= 20) or placebo (n= 20). Subjects with comorbid depression (clinician HAMD> 16) were excluded. Results found no significant difference between mean change on the Liebowitz Social Anxiety Scale with SJW (11.4) and placebo (13.2), P= 0.27, effect size=− 0.09. Post-hoc analyses found larger effects sizes associated with increased baseline severity, omitting patients with variable scores (±30%) during the first week, and use of self-report HAMD scores for exclusion. Results of the study fail to provide evidence for the efficacy of SJW in social phobia. The impact of methodologic improvements on signal detection, while suggestive of improvement, remains to be established.