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St. John's Wort graphic

St. John's Wort

St. John's Wort is an extract from the herb tops and flowers of the Hypericum perforatum plant and it is thought that it was first used in Greek and Roman times.

 

Claimed health benefits

Symptomatic treatment of mild / moderate depression

 

Evidence for health benefits

The antidepressant action of St John's Wort has been shown in many well conducted clinical trials. One 4-week, randomized, placebo-controlled, double blind-study in which 39 patients with depression with somatic symptoms were treated with 900 mg Hypericum extract found that 70% of the treated patients were free of symptoms after 4 weeks. These symptoms included lack of activity, tiredness, fatigue, and disturbed sleep [1].

A review of 23 such trials including a total of 1757 outpatients with mild or moderately severe depressive disorders concluded that there is evidence that extracts of Hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders, but that further studies comparing extracts with standard antidepressants in well-defined groups of patients and comparing different extracts and doses are needed [2].

 

Cautions

St Johns Wort has been associated with gastrointestinal irritations, allergic reactions, tiredness, and restlessness although the side effects are extremely rare.

St. John's Wort should not be used with prescription antidepressants

St John's Wort has an encouraging safety profile. However, as most of the current data originate from short-term investigations, long term safety is unknown [3].

It is important to remember that dietary supplements do not have to be manufactured to any standards, and thus supplements from different manufacturers are likely to vary in quality. [tell me more]

There is a distinct lack of scientific data on the safety of herbal supplements when taken by children and pregnant or breast feeding women. If you fit into these categories do not take herbal supplements.

As with all dietary supplements, make sure that you inform your physician of what you are taking when you visit.

 

Dose

300 mg Hypercium three times a day results in therapeutic effects [1]. St John's Wort should be taken with food.

Choosing the brand
The constituent of Hypericum extract that is responsible for the antidepressant effect has not been identified [4].

Contamination
The people who harvest herbs for these products are not qualified botanists and there have been many reports of unwanted and sometimes poisonous parts of the plants or other plants being picked and added to herbal remedies. Some journals have speculated that liver damage of unknown origin might stem from herbs more often than doctors realize, and a representative for the Center for Disease Control and Prevention even suggested that some herbal supplements may be contaminated with real drugs for extra "punch".

Cost per month
$10.75 (based on prices in a mid-western city, March, 2000)

 

For more information go to http://nccam.nih.gov/health/stjohnswort/index.htm

 

References

1. Hubner WD, Lande S, Podzuweit H: Hypericum treatment of mild depressions with somatic symptoms. J Geriatr Psychiatry Neurol Oct;7 Suppl 1:S12-4, 1994.

2. Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D: St John's wort for depression--an overview and meta-analysis of randomised clinical trials. BMJ Aug 3;313(7052):253-8, 1996.

3. Ernst E, Rand JI, Barnes J, Stevinson C: Adverse effects profile of the herbal antidepressant St. John's wort (Hypericum perforatum L.). Eur J Clin Pharmacol Oct;54(8):589-94, 1998.

4. Nordfors M, Hartvig P: St John's wort against depression in favour again. Lakartidningen Jun 18;94(25):2365-7, 1997.