St. John’s wort (Emily Wood, Purdue College of Pharmacy

St. John’s Wort

Scientific name: Hypericum perforatum L.

https://www.researchgate.net/figure/Scheme-1-Structures-of-St-Johnswort-main-antidepressant-components_fig1_6442263 https://sungodmedicinals.com/pages/herb-spotlight-st-johns-wort Common names: Goatweed, Klamath weed

https://www.nccih.nih.gov/health/st-johns-wort-and-depression-in-depth

History St. John’s wort has been used in traditional European medicine for centuries. It is named after John the Baptist due to the yellow-flowered plant blooming around the same time of year as St. John the Baptist day. Having been cited by well-known ancient Greek physicians such as Hippocrates, it was primarily used as an antidepressant and a diuretic. It was also noted for its healing properties. Today it is most commonly used to treat mild-to-moderate depression. It is available over the counter in the United States or by prescription in much of Europe.

Common uses - Anti-inflammation - Antiviral/HIV - Depression - Irritable bowel syndrome - Menopause symptoms - Restless leg syndrome - Skin conditions - Wound healing

Pharmacology St. John’s wort is comprised of a large number of chemicals that can have a variety of effects. Most notably, it contains hypericin and hyperforin, which are thought to provide the supplement’s main pharmacological effects. Studies have shown that it inhibits the reuptake of several neurotransmitters, including norepinephrine, dopamine, and serotonin.

Dosage This supplement is available in a range of forms, mainly capsules. Other forms include tablets, tinctures, teas, and lotions. It is also available dried or powdered. Dosing can range from 200 to 1,800 milligrams daily, with the most common being 900 milligrams divided into three daily doses to treat depression. The lotion generally contains 3-5% hyperforin or 0.3% hypericin.

https://minoritynurse.com/herbal-medicine-everything-you-need-to-know-about-st-johns-wort/

Safety and Effectiveness This supplement has been found to be comparable to antidepressants for treatment of mild-tomoderate depression. It also might be effective at healing wounds and treating symptoms of menopause. There is not enough evidence to know if it is effective for any other conditions. St. John’s wort should not be taken if pregnant or breastfeeding.

Side Effects - Dry mouth - Nausea - Rash - Fatigue - Dizziness - Restlessness - Insomnia - Headache - Sunlight sensitivity

https://www.heb.com/product-detail/nature-s-bountyst-john-s-wort-standardized-extract-300-mgcapsules/1348607

Interactions St. John’s wort interacts with a wide range of medications, including antidepressants, birth control pills, some heart and cholesterol medications, antivirals, and warfarin. This is not an exhaustive list. It is important to talk to your doctor before taking this supplement.

Article Summary A study published in 2017 was done with the goal of creating a more comprehensive conclusion on the effectiveness of St. John’s wort for depression. They collected data from 27 different clinical trials done between 1960 and 2016, and then compiled this data. What they found was that St. John’s wort is comparable to SSRIs, a common type of antidepressant, in treating mild-tomoderate depression.

https://www.verywellmind.com/st-johns-wort-a2-89959 https://www.pinterist.com/pin/563724078329342441/

Professional Opinion St. John’s wort has a high risk of interactions with other medications and is not proven to be effective in treating much else besides mild depression. If a patient is interested in opting for natural methods to treat depression, then it may be something to discuss with their doctor. In general, however, I would not recommend this supplement. ~E Wood

References St. John’s Wort. Natural Products Database. Facts & Comparisons eAnswers. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed February 20, 2022. Mount Sinai. St. John’s wort. Accessed February 24, 2022. https://www.mountsinai.org/health-library/herb/st-johns-wort National for Complementary and Integrative Health. St. John’s wort. Accessed February 20, 2022. https://www.nccih.nih.gov/health/st-johns-wort Ng QX, Venkatanarayanan N, Ho CY. Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis. J Affect Disord. 2017;210:211-221. doi:10.1016/j.jad.2016.12.048