Depression is a state of mind producing a serious,
long term lowering of enjoyment of life or inability to visualize a happy
future. This disease cuts across all races, countries and continents and
therefore should be taken seriously. Depression has been the cause of most
people ending their life pre maturely. Hypericum perforatum(St John’s wort:
SJW) is a herbal medicine that exerts a range of antidepressant effects,
including serotonin, noradrenaline, and dopamine reuptake inhibition, gamma-aminobutyric
acid (GABA) and L glutamate pathway modulation, and has an interaction with the
neuroendocrine system.


The main reason I chose to work with article #1 over
article #2 was simply because article 1 deals with both moderate to mild
depression while in Article #2 Citation: Sarris J, Fava M, Schweitzer I, et al.
St. John’s wort (Hypericum perforatum) versus sertraline and placebo in major
depressive disorder: continuation data from a 26-week RCT. Pharmacopsychiatry.
2012;45:275–278. PubMed
it deals with only major depressive disorder hence it has a certain group in
mind already and is not opened to everyone.

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The first characteristic why I chose article #1 over
article #2 was because of the objective which I compared before settling on
article #1.  The objectives of the 2
articles vary immensely in article #1 the main objective is to compare the
efficacy and tolerability of Hypericum perforatum (St John’s wort extract) with
imipramine in patients with mild to moderate depression while in article #2 the
objective was to analyze the extension data from a 26-week randomized, double-blind,
restrained study of SJW (LI-160) vs. sertraline and placebo in main depressive
disorder. 124 participant “responders” prolonged treatment from week 8, until
week 26.

Another characteristic of why I chose this article
was because of how they were able to select their participants. The method they
chose to select participants was,  Women
and Men were included if they were aged 18 or older and found to have  mild to moderate depression without increased
suicidal ideation or homicidal ideation and if they fulfilled ICD-10
(international classification of diseases, 10th revision) criteria for a
depressive episode or recurrent depressive disorder (ICD-10 codes F32.0 or
F33.0 and F32.1 or F33.1). All participants gave written, informed consent
before entering the study. Partakers were expected to have a score of ?18 on the 17 item
Hamilton depression rating scale on consecutive visits to be included in the
study, the consecutive visits were supposed to be 2. A lot of measures were
used to eliminate people who were not suitable people who were allergic to the
drug, pregnant, breastfeeding or had a serious disease which would have
complicated the study of the drug hence the findings which they were after was
to be pure facts.

The other character why I chose this particular
article was on how the statistics were analyzed. Specific mental focus was paid
to the design and methodology of the research, such as using a sufficiently
large sample size to allow robust statistical analyses. The intention to treat
analysis and the analysis of data from participants who complied with the
protocol was planned prospectively.

 The study was
performed in compliance with the principles of the Declaration of Helsinki on
human rights in clinical research and European Union guidelines on good
clinical practice. All efficacy analyses were done on an intention to treat
basis and on the basis of compliance with protocols—that is, only data from
those participants who were treated for a minimum of 35 days that was analyzed.
Safety was evaluated using the intention to treat analysis.

Among the factors that can be considered  risky and can lead one to depression include
solitude, history of depression either to the said individual or in the family
gene, complicated grief, sleep disturbance and poor health status. Health
practitioners use  Anxiety and Depression
scales, the patient health questionnaire, the Edinburg postnatal depression
scale for pregnant women and postpartum to find out if someone is sinking into
depression. The age set for screening is above 18. The earlier it is discovered
the better as it can help someone from sinking deep and loosing hope.
Depression has led to a lot of suicide and substance abuse as recently as last
year the lead singer of Linkin Park, Bennington Chester took his own life after
a long battle with depression.


Depression is a risky health issue that needs to be
addressed as we are losing a lot of people through suicides which can be
preventable, also such attacks such as panic attacks and anxiety also lead to
more suicide deaths in the world. Awareness to depression and showering people
with love and affection can come in handy when dealing with depression. The
USPSTF recommends screening and adequate follow up of the patients by medical
practitioner. A great stride has been taken in developing drugs which help
people during these hard times.





1.      Woelk
H. Comparison of St John’s wort and imipramine for treating depression:
randomised controlled trial. BMJ. 2000 Sep 2;321(7260):536-9.





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