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St. John’s Wort Is Not Effective for Treatment of ADHD

No evidence of benefit as a single therapy for ADHD in children

St. John’s wort (Hypericum perforatum) is a commonly used herb that inhibits reuptake of serotonin, norepinephrine, and dopamine. In a randomized, double-blind, controlled trial, a team of naturopathic and allopathic physicians compared symptom control in a cohort of 54 children with ADHD (mean age, 9.8 years) who received St. John’s wort (300 mg, 3 times daily) or placebo for 8 weeks.

Treatment with St. John’s wort as the sole therapy for ADHD failed to demonstrate benefit over placebo, based on blinded clinical evaluation and standardized assessments on the Clinical Global Impression Improvement Scale or the ADHD Rating Scale-IV at 1, 2, 4, 6, and 8 weeks. Adverse affects were similar in children who received placebo and St. John’s wort. Quality-of-life scores also did not differ between groups.

Comment: Few rigorous clinical trials of complementary therapies in children have been published. Despite the limitations of a small cohort and a short therapeutic trial, this carefully conducted study shows no benefit of St. John’s wort as a single therapy for ADHD. This type of solid evidence is needed to help frustrated families weigh the benefits of alternative therapies when standard, approved treatments are unsatisfactory.

— F. Bruder Stapleton, MD

Published in Journal Watch Pediatrics and Adolescent 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.

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Chan E. Quality of efficacy research in complementary and alternative medicine. JAMA 2008 Jun 11; 299:2685.

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• Medline abstract (Free)