IMB ruling on herbal depression treatment set to go to High Court

The Irish Medicines Board decision to make St John's Wort a prescription-only medication from next year could be challenged in…

The Irish Medicines Board decision to make St John's Wort a prescription-only medication from next year could be challenged in the High Court, it emerged yesterday.

The Health Producers' Alliance, which includes manufacturers, wholesalers, retailers and medical herbalists, has sought legal advice and is considering seeking a judicial review of the IMB decision.

Extracts of St John's Wort (hypericum perforatum) is used as a natural treatment for mild and moderate depression. It has been available from health shops and over the counter at pharmacies for many years. However, the IMB ruled in September that a prescription will be required for the product from January 1st, 2000.

"Consumers have moved from a position of disbelief to one of outrage," Ms Erica Murray of the Health Producers' Alliance said. They have already collected 30,000 signatures for their petition calling for a reversal of the decision.

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The Green Party started its own State-wide campaign yesterday, calling on the Minister for Health and Children, Mr Cowen, to reverse the IMB move. The decision was totally bizarre and inexplicable, the Green TD, Mr Trevor Sargent, said.

The Green Party has called on members of the public opposed to the decision to write to their TD and to Mr Cowen.

A Co Kildare GP, Dr Andrew Rynne, said the IMB decision was outrageous and St John's Wort had been taken for 2,000 years without any adverse effect. Making the supplement prescription-only would not provide the consumer with any additional protection, he said.

An IMB spokesman said concerns about St John's Wort were raised during a review of data from applications for authorisation of other products containing hypericum perforatum. The board believed that patients with mild to moderate depression, which the product was used to treat, should be under medical supervision. Self-diagnosis and self-medication were inappropriate, the IMB said.

The board was also concerned about the side-effects of hypericum perforatum, and advertising claims that there were no such effects. It had been reported that it could interfere with the breakdown of common prescription medications.

It was unclear how hypericum perforatum worked, but it was reported to act as a monoamine oxidase inhibitor (MAOI), the IMB said.

"Prescription MAOIs must be used with care because there is a risk of hypertensive crisis when they are taken with over-the-counter sympsthomimetics [e.g. cough mixtures], anti-depressants or foods containing tryamine [e.g. red wine or cheese]," the spokesman said. "The IMB is concerned that similar interactions may occur with hypericum perforatum."

Only the pharmaceutical companies could benefit from the IMB decision, Mr Sargent said.

"The bottom line is that the Irish Medicines Board, if it persists in making St John's Wort a prescription-only medicine, will be seen as a puppet of the pharmaceutical industry in the public mind," he said.

"It is sad that this campaign is trying to save the Irish Medicines Board from its own stupidity in appearing to become a slave of pharmaceutical interests."