St. John's Wort, also known as hypericum perforatum, is a popular herbal supplement that is often used as an alternative self-prescribed treatment for depression and anxiety. The mechanism of action of St. John's Wort is not well understood, but it is thought to act on the central nervous system by inhibiting the re-uptake of essential neurotransmitters, proteins in the brain that control how the nervous system functions. These neurotransmitters have relevant roles with the symptoms of depression.
Clinical Studies
St. John's wort has very inconsistent reports in regards to the clinical treatment of depression, generally showing to be ineffective or only effective against minor depression, according to MedlinePlus. While the effect of St. John's Wort against minor depression is not better than anti-depressants, the apparent side effects might be less noticeable with St. John's Wort compared with other anti-depressants. Further research is necessary to determine the effectiveness and safety of St John's Wort as a clinical treatment of depression
Side Effects
St. John's Wort usage can be associated with several adverse reactions including gastrointestinal disorders, insomnia, vertigo, fatigue, increased hypertension and sun hypersensitivity. According to Dr. Chiara Garrovo in the 2006 issue of "Phytotherapy Research," St. John's Wort ingested by female rats can decrease important liver detoxification enzymes in the fetus and child during pregnancy and lactation respectively. Since the exact effect of this compound on human child development is unclear, pregnant mothers should avoid its usage until more research can be performed, according Garrovo.
Drug Interactions
St. John's Wort is contraindicated with many prescribed medications, including anti-depressants, HIV-medication and warfarin, causing severe adverse reactions. St. John's Wort should never be ingested without first consulting a doctor. According to the 2001 issue of the "British Journal of Pharmacology," Michael D Perloff indicates St. John's Wort can decrease the therapeutic effects of digoxin and cyclosporin, important prescribed medication for congestive heart failure and organ transplantation respectively.
Improper Regulation
St. John's Wort, despite having many potential serious drug interactions, is not properly regulated by the Food & Drug Administration. St. John's Wort is sold within the U.S. without a standard dose or proper disclosure of its many potential adverse effects. As advice for any herbal supplement, St. John's Wort should be used as cautiously as an alternative natural self-treatment of depression and anxiety, however, at the first sign of any adverse reaction, immediately discontinue the supplement and consult a doctor.
References
- MedlinePlus: St. John's Wort
- Wiley Online Library: St John's wort modulation and developmental expression of multidrug transporters in the rat; Chiara Garrovo, Anna Rosati, Fiora Bartoli and Giuliana Decorti; April 2006
- "British Journal of Pharmacology"; Saint John's Wort: An in Vitro Analysis of P-glycoprotein Induction Due to Extended Exposure; Michael D Perloff, Lisa L von Moltke, Elke Störmer, Richard I Shader, and David J Greenblatt; September 2001
