Hypericin, a component of the herb St. John's Wort, is a supplement that many people take to help with symptoms of depression. St. John's Wort has been documented in several clinical trials to have antidepressant properties. However, the FDA has not approved St. John's Wort or Hypericin as a cure for depression and it may not be safe or effective for every user.
History
St. John's Wort was first reported in 1630 by German doctor Angelo Sala to be useful in treating depression. 200 years later Dr. J. Kerner referred to in his writings the use of St. John's Wort to treat melancholia, which is what people at the time called depression. The German doctor K. Daniel described treatment of 20 depressed patients with St. John's Wort in 1939. In 1984, the German Federal Health Agency released a monograph describing the antidepressants effects of St. John's Wort, and the first English report on St. John's Wort in clinical trials was in 1994. Germany is still the country with the highest use of St. John's Wort to treat depression.
Antidepressant Properties
St. John's Wort is the most clinically studied herbal supplement. A 2004 meta-analysis of 27 trials by Linde and Rowe found that St. John's Wort is significantly more effective than placebo in treating depression. Ten studies have found supplementation with St. John's Wort to be comparable to treatment with tricyclic antidepressants, and three studies found St. John's Wort to be as effective as selective serotonin reuptake inhibitors or SSRIs, which are the most commonly prescribed antidepressants.
Misconceptions
St. John's Wort has been theorized to be antidepressant by blocking reuptake of serotonin, decreasing binding to benzodiazapene receptors, and inhibiting monoamine oxidase, the enzyme that breaks down serotonin, dopamine, and norepinephrine. This clearly suggests there may be multiple active components in St. John's Wort. Hypericin has antiviral effects, and until recently was thought to be the main antidepressant chemical in St. John's Wort.
Though St. John's Wort supplements are standardized to hypericin concentration, hypericin has not been proven to have antidepressant activity. In fact, the main chemical attributed to St. John's Wort's antidepressant activity, in a dose-dependent manner, is hyperforin. St. John's Wort supplements are not standardized to hyperforin concentration, making supplements available on the market highly variable. The FDA does not regulate concentrations of supplements or efficacy, and as such St. John's Wort is not cleared as an official treatment for depression in the United States.
References
- "St. John's Wort and its Active Principles in Depression and Anxiety," Walter Erhard Müller; 2005
- "Textbook of Integrative Mental Health Care,"James Lake; 2007
