ABSTRACT
The phloroglucinol derivative hyperforin has been recently shown to be a major antidepressant component in the extract of Hypericum perforatum. Experimental studies clearly demonstrated its activity in different behavioral models of depression. Moreover clinical studies linked the therapeutic efficacy of Hypericum extracts to their hyperforin content, in a dose‐dependent manner.
The molecular mechanism of action of hyperforin is still under investigation. Hyperforin has been shown to inhibit, like conventional antidepressants, the neuronal uptake of serotonin, norepinephrine and dopamine. However, hyperforin inhibits also the uptake of γ‐aminobutyric acid (GABA) and L‐glutamate. The uptake inhibition by hyperforin does not involve specific binding sites at the transporter molecules; its mechanism of action seems to be related to sodium conductive pathways, leading to an elevation in intracellular Na+ concentration. Other additional mechanisms of action of hyperforin, involving ionic conductances as well synaptosomal and vesicular function, have been suggested. In addition to its antidepressant activity, hyperforin has many other pharmacological effects in vivo (anxiolytic‐like, cognition‐enhancing effects) and in vitro (antioxidant, anticyclooxygenase‐1, and anticarcinogenic effects). These effects could be of clinical importance. On the other hand, the role of hyperforin in the pharmacological interactions occurring during Hypericum extract therapy must be fully investigated. Hyperforin seems to be responsible for the induction of liver cytochrome oxidase enzymes and intestinal P‐glycoprotein.
Several pharmacokinetic studies performed in rats and humans demonstrated oral bioavailability of hyperforin from Hypericum extract. Only recently a new chromatographic method for detection of hyperforin in the brain tissue has been developed and validated. Taking into account the chemical instability of hyperforin, current efforts are directed to the synthesis of new neuroactive derivatives.
Keywords: Antidepressants, Axiolytics, Drug interactions, Hypericum perforatum, Hyperforin, St. John's wort
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REFERENCES
- 1. Adam P, Arigoni D, Bacher A, Eisenreich W. Biosynthesis of hyperforin in Hypericum perforatum. J Med Chem 2002;45:4786–4793. [DOI] [PubMed] [Google Scholar]
- 2. Albert D, Zündorf I, Dingermann T, Müller WE, Steinhilber D, Werz O. Hyperforin is a dual inhibitor of cyclooxygenase‐1 and 5‐lipoxygenase. Biochem Pharmacol 2002;64:1767–1775. [DOI] [PubMed] [Google Scholar]
- 3. Bauer S, Strömer E, Graubaum HJ, Roots I. Determination of hyperforin, hypericin and pseudohypericin in human plasma using high‐performance liquid chromatography analysis with fluorescence and ultraviolet detection. J Chromatogr B 2001;765:29–35. [DOI] [PubMed] [Google Scholar]
- 4. Bergonzi MC, Bilia AR, Gallori S, Guerrini D, Vincieri FF. Variability in the content of the constituents of Hypericum perforatum L. and some commercial extracts. Drug Dev Ind Pharm 2001;27(6):491–497. [DOI] [PubMed] [Google Scholar]
- 5. Bhattacharya SK, Chakrabarti A, Chatterjee SS. Activity profiles of two hyperforin‐containing Hypericum extracts in behavioural models. Pharmacopsychiatry 1998;31(Suppl 1):22–29. [DOI] [PubMed] [Google Scholar]
- 6. Biber A, Fischer H, Römer A, Chatterjee SS. Oral bioavailability of hyperforin from Hypericum extracts in rats and human volunteers. Pharmacopsychiatry 1998;31(Suppl 1):36–43. [DOI] [PubMed] [Google Scholar]
- 7. Bilia AR, Bergonzi MC, Morgenni F, Mazzi G, Vincieri FF. Evaluation of chemical stability of St. John's wort commercial extract and some preparations. Int J Pharm 2001;213:199–208. [DOI] [PubMed] [Google Scholar]
- 8. Bilia AR, Gallori S, Vincieri FF. St. John's wort and depression. Efficacy, safety and tolerability: An update. Life Sci 2002;70:3077–3096. [DOI] [PubMed] [Google Scholar]
- 9. Bombardelli E, Morazzoni P. Hypericum perforatum. Fitoterapia 1995;66:43–68. [Google Scholar]
- 10. Bray BJ, Brennan NJ, Perry NB, Menkes DB, Rosengren RJ. Short term treatment with St. John's wort, hypericin or hyperforin fails to induce CYP450 isoforms in the Swiss Webster mouse. Life Sci 2002;70:1325–1335. [DOI] [PubMed] [Google Scholar]
- 11. Brenner R, Azbel V, Madhusoodanan S, Pawlowska M. Comparison of an extract of Hypericum (LI 160) and sertraline in the treatment of depression: A double‐blind, randomized pilot study. Clin Ther 2000;22:411–419. [DOI] [PubMed] [Google Scholar]
- 12. Brondz I, Greibrokk T, Groth PA, Aasen AJ. The relative stereochemistry of hyperforin — an antibiotic from Hypericum perforatum L. Tetrahedron Lett 1982;23:1299–1300. [Google Scholar]
- 13. Brondz I, Greibrokk T, Groth PA, Aasen AJ. The absolute configuration of hyperforin, an antibiotic from Hypericum perforatum L., based on the crystal structure determination of its p‐bromobenzoate ester. Acta Chem Scand 1983;37:263–265. [Google Scholar]
- 14. Buchholzer ML, Dvorak C, Chatterjee SS, Klein J. Dual modulation of striatal acetylcholine release by hyperforin, a constituent of St. John's wort. J Pharmacol Exp Ther 2002;301:714–719. [DOI] [PubMed] [Google Scholar]
- 15. Butterweck V, Wall A, Liefländer‐Wulf U, Winterhoff H, Nahrstedt A. Effects of the total extract and fractions of Hypericum perforatum in animal assays for antidepressant activity. Pharmacopsychiatry 1997;30(Suppl1):117–124. [DOI] [PubMed] [Google Scholar]
- 16. Butterweck V, Petereit F, Winterhoff H, Nahrstedt A. Solubilized hypericin and pseudohypericin from Hypericum perforatum exert antidepressant activity in the forced swimming test. Planta Med 1998;64:291–294. [DOI] [PubMed] [Google Scholar]
- 17. Butterweck V, Jürgenliemk G, Nahrstedt A, Winterhoff H. Flavonoids from Hypericum perforatum show antidepressant activity in the forced swimming test. Planta Med 2000;66:3–6. [DOI] [PubMed] [Google Scholar]
- 18. Butterweck V, Winterhoff H, Herkenham M. St. John's wort, hypericin and imipramine: A comparative analysis of mRNA levels in brain areas involved in HPA axis control following short‐term and long‐term administration in normal and stressed rats. Mol Psychiatry 2001;6:547–564. [DOI] [PubMed] [Google Scholar]
- 19. Butterweck V, Nahrstedt A, Evans J, et al. In vitro receptor screening of pure constituents of St. John's wort reveals novel interactions with a number of GPCRs. Psychopharmacology 2002;162:193–202. [DOI] [PubMed] [Google Scholar]
- 20. Butterweck V, Christoffel V, Nahrstedt A, Petereit F, Spengler B, Winterhoff H. Step by step removal of hyperforin and hypericin: Activity profile of different Hypericum preparations in behavioral models. Life Sci 2003;73:627–639. [DOI] [PubMed] [Google Scholar]
- 21. Bystrov NS, Chernov BK, Dobrynin VN, Kolosov MN. The structure of hyperforin. Tetrahedron Lett 1975;32:2791–2794. [Google Scholar]
- 22. Calapai G, Crupi A, Firenzuoli F et al. Effects of Hypericum perforatum on levels of 5‐hydroxytryptamine, noradrenaline and dopamine in the cortex, diencephalons and brainstem of the rat. J Pharm Pharmacol 1999;51:723–728. [DOI] [PubMed] [Google Scholar]
- 23. Cantoni L, Rozio M, Mangolini A, Hauri L, Caccia S. Hyperforin contributes to the hepatic CYP3A‐inducing effect of Hypericum perforatum extract in the mouse. Toxicol Sci 2003;75:25–30. [DOI] [PubMed] [Google Scholar]
- 24. Cervo L, Rozio M, Elkalle‐Soppo CB, Guiso G, Morazzoni P, Caccia S. Role of hyperforin in the antidepressant‐like activity of Hypericum perforatum extracts. Psychopharmacology 2002;164:423–428. [DOI] [PubMed] [Google Scholar]
- 25. Chatterjee SS, Bhattacharya SK, Wonnemann M, Singer A, Müller WE. Hyperforin as a possible antidepressant component of Hypericum extracts. Life Sci 1998;63:499–510. [DOI] [PubMed] [Google Scholar]
- 26. Chatterjee SS, Nöldern M, Koch E, Erdelmeier C. Antidepressant activity of Hypericum perforatum and hyperforin: The neglected possibility. Pharmacopsychiatry 1998;31(Suppl 1):7–15. [DOI] [PubMed] [Google Scholar]
- 27. Chatterjee SS, Filippov V, Lishko P, Maximyuk O, Nöldern M, Krishtal O. Hyperforin attenuates various ionic conductance mechanisms in the isolated hippocampal neurons of rat. Life Sci 1999;65:2395–2405. [DOI] [PubMed] [Google Scholar]
- 28. Chatterjee SS, Erdelmeier C, Klessing K, Marmè D, Schächtele C. Stable hyperforin salts: Method for producing them and their use in the treatment of Alzheimer's disease. PCT WO 99/41220, August 19 1999.
- 29. Chatterjee SS, Biber A, Weibezahn C. Stimulation of glutamate, aspartate and gamma‐aminobutyric acid release from synaptosomes by hyperforin. Pharmacopsychiatry 2001;34(Suppl 1):11–19. [DOI] [PubMed] [Google Scholar]
- 30. Chen Y, Ferguson SS, Negishi M, Goldstein JA. Induction of human CYP2C9 by rifampicin, hyperforin and phenobarbital is mediated by the pregnane X receptor. J Pharmacol Exp Ther 2004;308:495–501. [DOI] [PubMed] [Google Scholar]
- 31. Chi JD, Franklin M. Measurement of hyperforin a constituent of St. John's wort in plasma by high‐performance liquid chromatography. J Chromatogr B 1999;735:285–288. [DOI] [PubMed] [Google Scholar]
- 32. Cui Y, Gurley B, Ang CYW, Leakey J. Determination of hyperforin in human plasma using solid‐phase extraction and high‐performance liquid chromatography with ultraviolet detection. J Chromatogr B 2002;780:129–135. [DOI] [PubMed] [Google Scholar]
- 33. Cui Y, Ang CY, Beger RD, Heinze TM, Hu L, Leakey J. In vitro metabolism of hyperforin in rat liver microsomal systems. Drug Metab Dispos 2004;32:28–34. [DOI] [PubMed] [Google Scholar]
- 34. De Vry J, Maurel S, Schreiber R, de Beun R, Jentzsch KR. Comparison of Hypericum extract with imipramine and fluoxetine in animal models of depression and alcoholism. Eur Neuropsychopharmacol 1999;9:461–468. [DOI] [PubMed] [Google Scholar]
- 35. Di Carlo G, Borrelli F, Ernst E, Izzo AA. St. John's wort: Prozac from the plant kingdom. TIPS 2001;22:292–297. [DOI] [PubMed] [Google Scholar]
- 36. Dürr D, Stieger B, Kullak‐Ublick GA, et al. St. John's wort induces intestinal P‐glycoprotein/MDR1 and intestinal and hepatic CYP3A4. Clin Pharmacol Ther 2000;68:598–604. [DOI] [PubMed] [Google Scholar]
- 37. Eckert GP, Müller WE. Effects of hyperforin on the fluidity of brain membranes. Pharmacopsychiatry 2001;34(Suppl 1):22–25. [DOI] [PubMed] [Google Scholar]
- 38. Ernst E. Second thoughts about safety of St. John's wort. Lancet 1999;354:2014–2016. [DOI] [PubMed] [Google Scholar]
- 39. Fisunov A, Lozavaya N., Tsintzadze T, Chatterje SS, Nöldern M, Krishtal O. Hyperforin modulates gating of P‐type Ca2+ current in cerebellar Purkinje neurons. Pflugers Arch 2000;440:427–434. [DOI] [PubMed] [Google Scholar]
- 40. Froestl B, Steiner B, Müller WE. Enhancement of proteolytic processing of the β‐amyloid precursor protein by hyperforin. Biochem Pharmacol 2003;66:2177–2184. [DOI] [PubMed] [Google Scholar]
- 41. Fugh‐Berman A. Herb‐drug interactions. Lancet 2000;355:134–138. [DOI] [PubMed] [Google Scholar]
- 42. Gambarana C, Ghiglieri O, Tolu PL, et al. Efficacy of an Hypericum perforatum (St John's wort) extract in preventing a condition of escape deficit in rats. Neuropsychopharmacology 1999;21:247–257. [DOI] [PubMed] [Google Scholar]
- 43. Gambarana C, Tolu PL, Masi F, et al. A study of the antidepressant activity of Hypericum perforatum on animal models. Pharmacopsychiatry 2001;34(Suppl 1):42–44. [DOI] [PubMed] [Google Scholar]
- 44. Gobbi M, Dalla Valle F, Ciapparelli C, et al. Hypericum perforatum L. extract does not inhibit 5‐HT transporter in rat brain cortex. Naunyn-Schmiedeberg's Arch Pharmacol 1999;360:262–269. [DOI] [PubMed] [Google Scholar]
- 45. Gobbi M, Moia M, Pirona L, Morazzoni P, Mennini T. In vitro binding studies with two Hypericum perforatum extracts, hyperforin, hypericin and biapigenin on 5‐HT6, 5‐HT7, GABAA/benzodiazepine, sigma, NPY‐Y1/Y2 receptors and dopamine transporters. Pharmacopsychiatry 2001;34(Suppl 1):45–48. [DOI] [PubMed] [Google Scholar]
- 46. Greeson JM, Sanford B, Monti DA. St. John's wort (Hypericum perforatum): A review of the current pharmacological, toxicological and clinical literature. Psychopharmacology 2001;153:402–414. [DOI] [PubMed] [Google Scholar]
- 47. Gurevich AI, Dobrynin VN, Kolosov MN, et al. Hyperforin an antibiotic from Hypericum perforatum L. Antibiot Khimioter 1971;16:510–513. [PubMed] [Google Scholar]
- 48. Heilmann J, Winkelman K, Sticker O. Studies on the antioxidative activity of phloroglucinol derivatives isolated from Hypericum species. Planta Med 2003;69:202–206. [DOI] [PubMed] [Google Scholar]
- 49. Hostanska K, Reichling J, Bommer S, Weber M, Saller R. Hyperforin, a constituent of St John's wort (Hypericum perforatum L.) extract, induces apoptosis by triggering activation of caspases and with hypericin synergistically exerts cytotoxicity towards human malignant cell lines. Eur J Pharm Biopharm 2003;56:121–132. [DOI] [PubMed] [Google Scholar]
- 50. Jensen AG, Hansen SH, Nielsen EO Adhyperforin as a contributor to the effect of Hypericum perforatum L. in biochemical models of antidepressant activity. Life Sci 2001;68:1593–1605. [DOI] [PubMed] [Google Scholar]
- 51. Johne A, Brockmöller J, Bauer S, Maurer A, Langheinrich M, Roots I. Pharmacokinetic interaction of digoxin with an herbal extract from St. John's wort (Hypericum perforatum). Clin Pharmacol Ther 1999;66:338–345. [DOI] [PubMed] [Google Scholar]
- 52. Kaehler ST, Sinner C, Chatterjee SS, Philippu A. Hyperforin enhances the extracellular concentrations of catecholamines, serotonin and glutamate in the rat locus coeruleus. Neurosci Lett 1999;262:199–202. [DOI] [PubMed] [Google Scholar]
- 53. Keller JH, Karas M, Müller WE, et al. Determination of hyperforin in mouse brain by high‐performance liquid chromatography/tandem mass spectrometry. Anal Chem 2003;75:6084–6088. [DOI] [PubMed] [Google Scholar]
- 54. Klusa V, Germane S, Nöldern M, Chatterjee SS. Hypericum extract and hyperforin: Memory‐enhancing properties in rodents. Pharmacopsychiatry 2001;34(Suppl 1):61–69. [DOI] [PubMed] [Google Scholar]
- 55. Koch E, Chatterjee SS. Hyperforin stimulates intracellular calcium mobilisation and enhances extracellular acidification in DDT1‐MF2 smooth muscle cells. Pharmacopsychiatry 2001;34(Suppl 1):70–73. [DOI] [PubMed] [Google Scholar]
- 56. Kraus GA, Dneprovskaia E, Nguyen TH, Jeon I. Synthesis of a model system for the preparation of phloroglucinol containing natural products. Tetrahedron 2003;59:8975–8978. [Google Scholar]
- 57. Krishtal O, Lozovaya N, Fisunov A, et al. Modulation of ion channels in rat neurons by the constituents of Hypericum perforatum. Pharmacopsychiatry 2001;34():Suppl 1):74–82. [DOI] [PubMed] [Google Scholar]
- 58. Laakmann G, Schüle C, Baghai T, Kieser M. St. John's wort in mild to moderate depression: The relevance of hyperforin for the clinical efficacy. Pharmacopsychiatry 1998;31(Suppl 1):54–59. [DOI] [PubMed] [Google Scholar]
- 59. Langosch JM, Zhou X‐Y, Heinen M, et al. St John's wort (Hypericum perforatum) modulates evoked potentials in guinea pig hippocampal slices via AMPA and GABA receptors. Eur Neuropsychopharmacol 2002;12:209–216. [DOI] [PubMed] [Google Scholar]
- 60. Maisenbacher P, Kovar KA. Adhyperforin: A homologue of hyperforin from Hypericum perforatum. Planta Med 1992;58:291–293. [DOI] [PubMed] [Google Scholar]
- 61. Malandro MS, Kilberg MS. Molecular biology of mammalian amino acid transporters. Annu Rev Biochem 1996;65:305–336. [DOI] [PubMed] [Google Scholar]
- 62. Marsh WL, Davies JA. The involvement of sodium and calcium ions in the release of amino acid neurotransmitters from mouse cortical slices elicited by hyperforin. Life Sci 2002;71:2645–2655. [DOI] [PubMed] [Google Scholar]
- 63. Maurer A, Johne A, Bauer S, et al. Interaction of St. John's wort extract with phenprocoumon. Eur J Clin Pharmacol 1999;55:A22. [Google Scholar]
- 64. Moore LB, Goodwin B, Jones SA, et al. St. John's wort induces hepatic drug metabolism through activation of the pregnane X receptor. Proc Natl Acad Sci USA 2000;97:7500–7502. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 65. Müller WE, Singer A, Wonnemann M, Hafner U, Rolli M, Schäfer C. Hyperforin represents the neurotransmitter reuptake inhibiting constituent of Hypericum extract. Pharmacopsychiatry 1998;31(Suppl 1):16–21. [DOI] [PubMed] [Google Scholar]
- 66. Müller WE, Singer A, Wonnemann M. Hyperforin‐antidepressant activity by a novel mechanism of action. Pharmacopsychiatry 2001;34(Suppl 1):98–102. [DOI] [PubMed] [Google Scholar]
- 67. Nahrstedt A, Butterweck V. Biologically active and other chemical constituents of the herb of Hypericum perforatum L. Pharmacopsychiatry 1997;30:129–134. [DOI] [PubMed] [Google Scholar]
- 68. Nahrstedt A. Antidepressant constituents of Hypericum perforatum In: Chrubasik S, Roufogalis BD, eds. Herbal medicinal products for the treatment of pain. Lismore : Southern Cross Univ. Press, 2000;144–153. [Google Scholar]
- 69. Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294(1):88–95. [PubMed] [Google Scholar]
- 70. Orth HCJ, Rentel C, Schmidt PC. Isolation, purity analysis and stability of hyperforin as a standard material from Hypericum perforatum L. J Pharm Pharmacol 1999;51(2):193–200. [DOI] [PubMed] [Google Scholar]
- 71. Orth HCJ, Hauer H, Erdelmeier CAJ, Schmidt PC. Orthoforin: The main degradation product of hyperforin from Hypericum perforatum L. Pharmazie 1999;54:76–77. [Google Scholar]
- 72. Ostrowski E. Untersuchung zur Analytik, 14C‐Markierung und Pharmakokinetik phenolischer Inhaltsstoffe von Hypericum perforatum L. Dissertation. Marburg 1988:118.
- 73. Panocka I, Perfumi M, Angeletti S, Ciccocioppo R, Massi M. Effects of Hypericum perforatum extract on ethanol intake, and on behavioral despair: A search for the neurochemical systems involved. Pharmacol Biochem Behav 2000;66(1):105–111. [DOI] [PubMed] [Google Scholar]
- 74. Perfumi M, Panocka I, Ciccocioppo R, Vitali D, Froldi R, Massi M. Effects of a methanolic extract and a hyperforin‐enriched CO2 extract of Hypericum perforatum on alcohol intake in rats. Alcohol Alcohol 2001;36(3):199–206. [DOI] [PubMed] [Google Scholar]
- 75. Perloff MD, Moltke LL, Störmer E, Shader RI, Greenblatt DJ. St. John's wort: An in vitro analysis of P‐glycoprotein induction due to extended exposure. Br J Pharmacol 2001;134:1601–1608. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 76. Philipp M, Kohnen R, Hiller K. Hypericum extract versus imipramine or placebo in patients with moderate depression: randomized multicentre study of treatment for eight weeks. Br Med J 1999;319:1534–1538. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 77. Philippu A. In vivo neurotransmitter release in the locus coeruleus — Effects of hyperforin, inescapable shock and fear. Pharmacopsychiatry 2001;34(Suppl 1):111–115. [DOI] [PubMed] [Google Scholar]
- 78. Rezvani A, Overstreet D, Yang Y, Clark E. Attenuation of alcohol intake by extract of Hypericum perforatum (St John's wort) in two different strains of alcohol‐preferring rats. Alcohol Alcohol 1999;34:699–705. [DOI] [PubMed] [Google Scholar]
- 79. Roby CA, Anderson GD, Kantor E, Dryer DA, Burstem AH. St. John's wort: Effect on CYP3A4 activity. Clin Pharmacol Ther 2000;67:451–457. [DOI] [PubMed] [Google Scholar]
- 80. Roz N, Mazur Y, Hirshfeld A, Rehavi M. Inhibition of vesicular uptake of monoamines by hyperforin. Life Sci 2002;71:2227–2237. [DOI] [PubMed] [Google Scholar]
- 81. Roz N, Rehavi M. Hyperforin inhibits vesicular uptake of monoamines by dissipating pH gradient across synaptic vesicle membrane. Life Sci 2003;73:461–470. [DOI] [PubMed] [Google Scholar]
- 82. Ruschitzka F, Meier PJ, Turina M, Luschner TF, Noll G. Acute heart transplant rejection due to St. John's wort. Lancet 2000;355:548–549. [DOI] [PubMed] [Google Scholar]
- 83. Schempp CM, Pelz K, Wittmer A, Schöpf E, Simon JC. Antibacterial activity of hyperforin from St. John's wort, against multiresistant Staphylococcus aureus and gram‐positive bacteria. Lancet 1999;353(19):2129–2132. [DOI] [PubMed] [Google Scholar]
- 84. Schempp CM, Winghofer B, Ludtke R, Simon‐Haarrhaus B, Schopf E, Simon JC. Topical application of St. John's wort (Hypericum perforatum L.) and its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells. Br J Dermatol 2000;142:979–984. [DOI] [PubMed] [Google Scholar]
- 85. Schempp CM, Kirkin V, Simon‐Haarrhaus B, et al. Inhibition of tumor cell growth by hyperforin, a novel anticancer drug from St. John's wort that acts by induction of apoptosis. Oncogene 2002;21:1242–1250. [DOI] [PubMed] [Google Scholar]
- 86. Schrader E. Equivalence of St John's wort extract (Ze 117) and fluoxetine: A randomized, controlled study in mild‐moderate depression. Int Clin Psychopharmacol 2000;5:61–68. [DOI] [PubMed] [Google Scholar]
- 87. Shan MD, Hu LH, Chen ZL. Three new hyperforin analogues from Hypericum perforatum. J Nat Prod 2001;64:127–130. [DOI] [PubMed] [Google Scholar]
- 88. Shellenberg R, Sauer S, Dimpfel W. Pharmacodynamic effects of two different Hypericum extracts in healthy volunteers measured by quantitative EEG. Pharmacopsychiatry 1998;31(Suppl 1):44–53. [DOI] [PubMed] [Google Scholar]
- 89. Shelton RC, Keller MB, Gelenberg A, et al. Effectiveness of St. John's wort in major depression. JAMA 2001;285:1978–1986. [DOI] [PubMed] [Google Scholar]
- 90. Simbrey K, Winterhoff H, Butterweck V, Extracts of St. John's wort and various constituents affect β‐adrenergic binding in rat frontal cortex. Life Sci 2004;74(8):1027–1038. [DOI] [PubMed] [Google Scholar]
- 91. Simmen U, Higelin J, Berger‐Büter K, Schaffner W, Lundstrom K. Neurochemical studies with St. John's wort in vitro. Pharmacopsychiatry 2001;34(Suppl 1):137–142. [DOI] [PubMed] [Google Scholar]
- 92. Singer A, Wonnemann M, Müller WE. Hyperforin, a major antidepressant constituent of St. John's wort, inhibits serotonin uptake by elevating free intracellular Na+ . J Pharmacol Exp Ther 1999;290:1363–1368. [PubMed] [Google Scholar]
- 93. Toll L, Howard BD. Role of Mg2+‐ATPase and pH gradient in storage of catecholamines in synaptic vesicles. Biochemistry 1978;17:2517–2523. [DOI] [PubMed] [Google Scholar]
- 94. Trifunović S, Vajs V, Macura S, et al. Oxidation products of hyperforin from Hypericum perforatum. Phytochemistry 1998;49:1305–1310. [DOI] [PubMed] [Google Scholar]
- 95. Vandenbogaerde A, Zanoli P, Puia G et al. Evidence that total extract of Hypericum perforatum affects exploratory behaviour and exerts anxiolytic effects in rats. Pharmacol Biochem Behav 2000;65:627–633. [DOI] [PubMed] [Google Scholar]
- 96. Vajs V, Vugdelija S, Trifunović S, et al. Further degradation product of hyperforin from Hypericum perforatum (St. John's Wort). Fitoterapia 2003;74:439–444. [DOI] [PubMed] [Google Scholar]
- 97. Verotta L, Appendino G, Belloro E, Jakupovic J, Bombardelli E. Furohyperforin, a prenylated phloroglucinol from St. John's wort (Hypericum perforatum). J Nat Prod 1999;62:770–774. [DOI] [PubMed] [Google Scholar]
- 98. Verotta L, Appendino G, Jakupovic J, Bombardelli E. Hyperforin analogues from St. John's wort (Hypericum perforatum). J Nat Prod 2000;63(3):412–415. [DOI] [PubMed] [Google Scholar]
- 99. Verotta L, Appendino G, Belloro E, et al. Synthesis and biological evaluation of hyperforin analogues. Part I. Modification of the enolized cyclohexanedione moiety. J Nat Prod 2002;65:433–438. [DOI] [PubMed] [Google Scholar]
- 100. Verotta L. Hypericum perforatum, a source of neuroactive lead structure. Curr Top Med Chem 2003;3(2):187–201. [DOI] [PubMed] [Google Scholar]
- 101. Volz HP. Controlled clinical trials of Hypericum extracts in depressed patients: An overview. Pharmacopsychiatry 1997;30:72–76. [DOI] [PubMed] [Google Scholar]
- 102. Wang E, Barechi‐Roach M, Johnson WW. Quantitative characterization of direct P‐glycoprotein inhibition by St John's wort constituents hypericin and hyperforin. J Pharm Pharmacol 2004;56:123–128. [DOI] [PubMed] [Google Scholar]
- 103. Watkins RE, Maglich JM, Moore LB et al. A crystal structure of human PXR in complex with the St. John's wort compound hyperforin. Biochemistry 2003;42:1430–1438. [DOI] [PubMed] [Google Scholar]
- 104. Woelk H. Comparison of St. John's wort and imipramine for treating depression: randomised controlled trial. Br Med J 2000;321:536–539. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 105. Wonnemann M, Singer A, Müller WE. Inhibition of synaptosomal uptake of 3H‐L‐glutamate and 3H‐GABA by hyperforin, a major constituent of St. John's wort: The role of amiloride sensitive sodium conductive pathways. Neuropsychopharmacology 2000;23(2):188–197. [DOI] [PubMed] [Google Scholar]
- 106. Wonnemann M, Singer A, Siebert B, Müller WE. Evaluation of synaptosomal uptake inhibition of most relevant constituents of St. John's wort. Pharmacopsychiatry 2001;34(Suppl 1):148–151. [DOI] [PubMed] [Google Scholar]
- 107. Wright CW, Gott M, Grayson B et al. Correlation of hyperforin content of Hypericum perforatum (St. John's wort) extracts with their effects on alcohol drinking in C57B1/6J mice: A preliminary study. J Psychopharmacol 2003;17:403–408. [DOI] [PubMed] [Google Scholar]
- 108. Zanoli P, Rivasi M, Baraldi C, Baraldi M. Pharmacological activity of hyperforin acetate in rats. Behav Pharmacol 2002;13:645–651. [DOI] [PubMed] [Google Scholar]
- 109. Zou L, Harkey MR, Henderson GL. Effects of herbal components on cDNA‐expressed cytochrome P450 enzyme catalytic activity. Life Sci 2002;71:1579–1589. [DOI] [PubMed] [Google Scholar]