St. John’s wort does not appear to improve the symptoms of attention-deficit/hyperactivity disorder (ADHD) in children and teens in comparison with a placebo, according to an article released on June 10, 2008 in JAMA.

Hypericum perforatum, also called St. John’s wort, is a flowering plant often used in alternative medicine to treat depression. Many studies have been used to test its efficacy for this and other indications. Its active chemical is called hypercin, and some of its efficacy is attributed to this substance.

ADHD is a neurological disorder that generally appears in childhood, presenting with symptoms of hyperactivity, forgetfulness, and being easily distracted. This disease affects between 3-12% of children in the United States, according to the background information in the article. Up to 30% of these children have no response to medications, or have adverse effects when taking them such as nausea, insomnia, or weight loss. For these reasons, many parents seek complementary or alternative medicine for their children with ADHD. Complementary or alternative medicine treatments used for pediatric ADHD include massage, dietary changes, dietary supplements, and herbal treatments. In the United States, the most common herbal treatments used by children with ADHD are St John’s wort, Echinacea species, and Ginkgo biloba,” write the authors.

To investigate St. John’s wort as a remedy for the symptoms of ADHD, Wendy Weber, N.D., Ph.D., M.P.H., of Bastyr University, Kenmore, Wash., and colleagues performed a trial of 54 children and adolescents with ADHD between the ages of 6 and 17 years. Of these, 27 subjects were randomly assigned to receive 300mg of H. perforatum standardized to 0.3% hypercin, while the other 27 received a matched placebo. Treatment was administered three times daily for eight weeks while all other ADHD medications were forbidden.

No significant discrepancy was found between the two groups in terms of ADHD rating scale scores related to inattentiveness and hyperactivity in any of the 8 weeks of trials. There was also no difference found in the proportion of participants rated either much or very much improved in relation to ADHD symptoms on a second, different measurement scale called the Clinical Global Impression Improvement Scale. Finally, no statistically significant difference was found between the two groups for adverse events, including rash, nausea/vomiting, headache, or sunburn.
ing the trial.

The authors indicate that this means the efficacy of St. John’s wort is similar to that of a placebo. “To our knowledge, this is the first placebo-controlled trial of H. perforatum in children and adolescents. The results of this study suggest that administration of H. perforatum has no additional benefit beyond that of placebo for treating symptoms of child and adolescent ADHD,” they write.

Hypericum perforatum (St John’s Wort) for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Randomized Controlled Trial
Wendy Weber; Ann Vander Stoep; Rachelle L. McCarty; Noel S. Weiss; Joseph Biederman; Jon McClellan
JAMA. 2008; 299(22): 2633-2641.
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Written by Anna Sophia McKenney