Saint John's wort, an herbal inducer of the cytochrome P4503A4 isoform, may alleviate symptoms of Willis-Ekbom's disease

Saint John's wort, an herbal inducer of the cytochrome P4503A4 isoform, may alleviate symptoms of Willis-Ekbom's disease

Author Pereira Junior, José Carlos Google Scholar
Pradella-Hallinan, Márcia Lurdes de Cássia Autor UNIFESP Google Scholar
Alves, Rosana Cardoso Google Scholar
Institution Faculdade de Medicina de Jundiaí Pediatria
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
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.
Keywords Willis-Ekbom's Disease
Restless Legs Syndrome Treatment
Restless Legs Syndrome
Saint John's Wort
Thyroid Hormone
CYP4503A4
Language English
Date 2013-04-01
Published in Clinics. Faculdade de Medicina / USP, v. 68, n. 4, p. 469-474, 2013.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 469-474
Origin http://dx.doi.org/10.6061/clinics/2013(04)06
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000320002000006
SciELO ID S1807-59322013000400469 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/7715

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