St. John’s Wort in ADHD

A small trial showed no evidence of benefit.
St. John’s wort (Hypericum perforatum) is one of the most common herbal treatments given to children with attention-deficit/hyperactivity disorder (ADHD). Like atomoxetine (Strattera) — which is approved for use in children with ADHD — St. John’s wort is a norepinephrine reuptake inhibitor.
In a clinical trial conducted at a college of naturopathic medicine, 54 children and adolescents who met DSM-IV criteria for ADHD (age range, 6–17 years; mean age, 10) were randomized to thrice-daily St. John’s wort (300 mg) or placebo for 8 weeks after a 1-week placebo run-in. Nearly half the children previously had taken medications for ADHD. Based on blinded clinical evaluations and standardized assessments at 1, 2, 4, 6, and 8 weeks, no difference was observed in mean clinical improvement or in the proportion of children who met criteria for clinically significant improvement, on both intent-to-treat and per-protocol analyses. In addition, the number of adverse events did not differ between groups.
Comment: This study, purported to be the first placebo-controlled trial of St. John’s wort in children and adolescents, showed no benefit in ADHD. The study also is a good example of the type of rigorous research needed to assess many unstudied remedies, both "conventional" and "complementary."
Thomas L. Schwenk, MD
Published in Journal Watch General Medicine June 10, 2008

Citation(s):

Weber W et al. Hypericum perforatum (St John’s wort) for attention-deficit/hyperactivity disorder in children and adolescents: A randomized controlled trial. JAMA 2008 Jun 11; 299:2633.