St. Johns Wort: The Pharmacological Value - Research Proposal Example

? St. Johns Wort: The Pharmacological Value Overview Herbal medications existed and had been utilized long before synthetic drugs are formulated and distributed in the public. One of the widely used herbals nowadays is the St. John’s wort (SJW); this is scientifically referred to as Hypericum perforatum L., and had been commonly employed as traditional cure for a variety of conditions, ranging from “excitability, neuralgia, fibrositis, sciatica...(including) treatment of wounds.”1 Produced either naturally or extensively processed for drug extraction, the clinical mechanism of this type of herb manifests similar drug actions. As extracted through hydroalcoholic chemical agents, such process emits production of six distinct groups: “naphthodianthrones, phloroglucinols...proanthocyanidins.”2 In more ways, each is accounted for to produce pharmacological reactions fit for human health improvement. In particular, naphthodianthrones is further chemically treated to produce stable compound, such as hypericin, which is said to act on cellular activities--inhibits protein viral synthesis and transmission of both MAO and serotonin neurotransmitters. More importantly, the chemical removal of hyperforin compound from phloroglucinols is relevant for this said to influence significant psychological neurotransmitters—“serotonic, dopamine, nordarenaline, and GABA.”3 Each produces satisfactory reactions in application to medical pharmacology. In this paper, the clinical value and safety of SJW are reviewed, where close scrutiny on pharmacological features is performed to evaluate its drug efficacy on human beings. Toxicological effects In human toxicology, the laboratory-extracted herbal compounds are said to set the stage for the ultimate utilization of SJW as human medication. As emphasized by Ang-Lee, Moss, and Yuan (2001), the regulating distribution of herbal medications, such as St. John’s wort, is quite lax compared to synthetic drugs.4 As indicated in Dietary and Supplement Health and Education Act of 1994, these agents are exempted from strict investigative supervisions from government sectors, including intense clinical trials and other safety surveillance that plague synthetic drug products. The approach, then, lawfully disregards toxicological reactions and drug interactions that bring adverse physiological conditions on human subjects. On the general side, there are a number of cases which exhibit toxicological effects of SJW on the body. Like any other drug effects, the herb can also cause discomforts and reactions on different organ systems, namely the gastrointestinal area, as well as cognitive and behavioral modifications. General symptoms of anxiety, dizziness, and headache are common, while specific effects may include skin reactions and irritations, increased photosensitivity to light stimulants, and manic episodes may occur. On rare occasions, some cases of severe adverse reactions may occur, such as neuropathy, muscle numbing, episodic hypertension and increased heart rate, sexually reproductive dysfunctions.5 In most episodes, these alterations in physiological and psychological status are reversible, and managed in clinical settings. On morbid pharmacological events, SJW possesses interactive drug capacities that either induce or reduce the efficacy of other drug agents. In a study on hepatic metabolism of SJW, it affirmed the involvement of “cytochrome P450 (CYP) 3A4 enzyme” in the overall metabolic action of drug agents. In specific terms, the metabolism and elimination of alprazolam agent from the subjects’ body manifest the large influence of SJW on the said enzyme. Significantly, this type of enzyme is said to be responsible for metabolizing majority of prescribed medications, from selective immunosuppressive, anti-depressants, fat-reducing drugs, antihistamines, and even glycoside agents.6 With the wide coverage of the affected metabolic enzyme, SJW can pose unknowing threats if not vigilantly used. The application of SJW, thereby, must be considered on the benefit versus risk ratio, and which section can top the other during pharmacological management. Drug Efficacy on Human Subjects While the early human inhabitants employed St. John’s wort as treatment for physical infirmities, several texts have proven the psychological impact of such herb on human population. As discussed earlier, SJW enacts on neurotransmitters in brain centers, enhancing psychological mood with its inhibitory compound agents, hypericin and hyperforin. In a comparative study between a chemical extract (WS 5570) of St. John’s wort and synthetic paroxetine as the effective drug for severe depressive state, it had been proven that the former is more superior in pharmacological efficacy than the latter. In the sample of 122 human subjects, majority (71%) responded well with SJW, while only 60% had been recorded for paroxetine as antidepressant.7 Compared to more advanced anti-depressive agents, the herbal drug proved to be of greater drug value compared to its synthetic counterparts. In further scrutiny, not only is SJW indicated for depressive clients, it had been found to constructively influence psychotherapy for somatoform disorders. In a randomized study conducted by Muller, Mannel, Murk, and Rahlfs (2004), research results yielded relevant figures; the subjects with somatoform disorders, but without depressive moods, exhibited better affective response compared to the group with apparent depressive manifestations.8 The study only shows that in the absence of depression, somatoform condition can also be independently treated through SJW. Yet, several studies showed its herbal failure in establishing the therapeutic benefit of SJW in managing cancer and HIV cases. On the first account, the promise of lessening the behavioral effects in attention-deficit hyperactive disorder (ADHD) had not been observed with the intensive administration of SJW beyond that of a placebo effect.9 Despite its mood-stabilizing features, the herb had not been able to reach therapeutic levels in effectively treating cases of ADHD. Even in the collaborative intervention of HIV conditions, hypericin compound is said to have antiretroviral elements that fight off HIV progression. However, the herbal drug only managed to produce photosensitivity reactions, with no clinical improvement with the viral debilitation.10 The series of studies in the herbal benefits of St. John’s wort objectively shows that although the herb shows positive outcomes on psycho-behavioral aspects of the human subjects, its efficacy in other therapeutic areas is not widely valuable. All in all, there is a good pharmacological safety net in herbal products, especially with SJW, where mild adverse reactions are common but severe toxicological effects are rare. More importantly, its beneficial success in psychological conditions, such as depression and somatoform disorders, are plausibly valid. Despite its shortcomings as an antiretroviral and as mood stabilizer in ADHD, the progress of SJW must not be disregarded. With further studies and research programs, the latter letdowns can be improved, where SJW can be more effective in those areas, and more. Read More