1. Saint John's wort, an herbal inducer of the cytochrome P4503A4 isoform, may alleviate symptoms of Willis-Ekbom's disease
- Author
-
Marcia Pradella-Hallinan, Rosana Cardoso Alves, and José Carlos Pereira
- Subjects
Drug ,Adult ,Male ,medicine.medical_specialty ,Thyroid Hormones ,congenital, hereditary, and neonatal diseases and abnormalities ,Adolescent ,media_common.quotation_subject ,Disease ,Pharmacology ,Severity of Illness Index ,Young Adult ,Restless Legs Syndrome ,Severity of illness ,medicine ,Thyroid Hormone ,Cytochrome P-450 CYP3A ,Humans ,Protein Isoforms ,Restless legs syndrome ,Child ,CYP4503A4 ,media_common ,Aged ,lcsh:R5-920 ,Hormone activity ,business.industry ,Plant Extracts ,Thyroid ,Age Factors ,nutritional and metabolic diseases ,General Medicine ,Clinical Science ,Middle Aged ,medicine.disease ,Surgery ,Saint john's wort ,medicine.anatomical_structure ,Treatment Outcome ,Cytochrome P-450 CYP3A Inhibitors ,Female ,business ,lcsh:Medicine (General) ,Willis-Ekbom's Disease ,Hypericum ,Hormone ,Restless Legs Syndrome Treatment ,Saint John's Wort - Abstract
OBJECTIVE: Certain drug classes alleviate the symptoms of Willis-Ekbom's disease, whereas others aggravate them. The pharmacological profiles of these drugs suggest that drugs that alleviate Willis-Ekbom's disease inhibit thyroid hormone activity, whereas drugs that aggravate Willis-Ekbom's disease increase thyroid hormone activity. These different effects may be secondary to the opposing actions that drugs have on the CYP4503A4 enzyme isoform. Drugs that worsen the symptoms of the Willis-Ekbom's disease inhibit the CYP4503A4 isoform, and drugs that ameliorate the symptoms induce CYP4503A4. The aim of this study is to determine whether Saint John's wort, as an inducer of the CYP4503A4 isoform, diminishes the severity of Willis-Ekbom's disease symptoms by increasing the metabolism of thyroid hormone in treated patients. METHODS: In an open-label pilot trial, we treated 21 Willis-Ekbom's disease patients with a concentrated extract of Saint John's wort at a daily dose of 300 mg over the course of three months. RESULTS: Saint John's wort reduced the severity of Willis-Ekbom's disease symptoms in 17 of the 21 patients. CONCLUSION: Results of this trial suggest that Saint John's wort may benefit some Willis-Ekbom's disease patients. However, as this trial was not placebo-controlled, the extent to which Saint John's wort is effective as a Willis-Ekbom's disease treatment will depend on future, blinded placebo-controlled studies.
- Published
- 2013