St. John’s wort (SJW) is a perennial herb native to Europe, North Africa, and western Asia. It has been introduced and naturalised in parts of Africa, Asia, Australia, and the Americas, and is found growing wild in neglected fields, dry pastures, rangelands, and along country roads.
The aerial flowering parts of SJW have been used in traditional European medicine for centuries to treat neuralgia, anxiety, neurosis, and depression. SJW was traditionally obtained from Eastern European countries, where it is still wild collected. It is cultivated in at least four provinces in Germany. Â [Source: American Botanical Council translation of Commission E monograph]
St. John’s wort and depression
St. John’s wort is widely known as a herbal treatment for depression. Â The active ingredient, hypericum, is thought to act through a similar mechanism to SSRI anti-depressants like prozac, and also has anti-inflammatory properties.
It is not difficultÂ to find research for and againstÂ the useÂ of St John’s wort in alleviating depression, but a 2008 Cochrane review of well-designed studies involving over 5,000 patientsÂ found:
The available evidence suggests that the hypericum extracts tested in the included trials:
- are superior to placebo in patients with major depression
- are similarly effective as standard antidepressants
- have fewer side effects than standard antidepressants
Curiously, the hypericum seemed more effective in the German studies that were reviewed.
Although SJW is available on prescription is many European countries, it is not supported by NHS clinical guidelines (see excellent info on SJW from Mind), nor officially sanctioned in the US. Â This is apparently because of interactions with other drugs – see side effects below.
According to US National Center for Complementary and Integrative Health, St. Johnâ€™s wort is known to affect how the body uses and breaks down a number of drugs and can cause serious side effects. The Center cautions as follows:
Serotonin is a brain chemical targeted by antidepressants. Combining St. Johnâ€™s wort and certain antidepressants can lead to a potentially life-threatening increase in serotonin levelsâ€”a condition called serotonin syndrome. Symptoms range from tremor and diarrhoea to very dangerous confusion, muscle stiffness, drop in body temperature, and even death.
Psychosis is a rare but possible side effect of taking St. Johnâ€™s wort, particularly in people who have or are at risk for mental health disorders, including bipolar disorder.
Taking St. Johnâ€™s wort can weaken many prescription medicines, such as:
- Antidepressants (see detailed list used by the NHS here)
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Digoxin, a heart medication
- Some HIV drugs including indinavir
- Some cancer medications including irinotecan
- Warfarin and similar medications used to thin the blood.
Other side effects of St. Johnâ€™s wort are usually minor and uncommon and may include upset stomach and sensitivity to sunlight. Also, St. Johnâ€™s wort is a stimulant and may worsen feelings of anxiety in some people.
St. John’s wort can be taken as an infusion in tea, or in tablet form (for the extract). According to Mind, the suggested dosage is 200mg to 1000mg of 0.3 per cent standardised hypericum extract per day, which is usually taken in two or three doses.
St. John’s Wort CapsulesÂ from Holland and Barrett contain 142mg per capsule, recommendedÂ to be taken as one capsule three times a day. (I have no affiliation to H&B; it’s just my nearest SJW supplier).
I have decided to give St. John’s wort a go – will record my findings, as ever, on the Depression Lab experiments page.