St. John’s Wort (Hypericum perforatum L.) is a common herbal remedy for the treatment of mild depression. According to the National Institute of Mental Health (NIMH) nearly 21 million American adults are affected by this condition. A desire for safer and less expensive remedies has propelled this supplement to the forefront of public awareness. In fact, St. John’s Wort is a broadly accepted treatment for mild to moderate depression in European countries. It has also been proved beneficial in treating Seasonal Affective Disorder(SAD).
Hypericum perforatum (Image Credit)
British scientists reviewed the results of over 26 clinical studies and after looking at the findings of over 1700 participants, they concluded that St. John’s Wort was effective for the treatment of mild to moderate depression. As one of the most popular herbal remedies sold today, there have been numerous reports and testimonials supporting the use of this herbal supplement.
The Cochrane Collaboration reviewed 29 studies in 5489 patients with depression and compared treatment with extracts of St. John’s wort for 4 to 12 weeks, placebo and other standard antidepressants. Patients from various countries were involved and most of the patients had symptoms ranging from mild to moderate levels. The result showed that St. John’s wort extracts were superior to placebo and other standard antidepressants, and only had fewer side effects than standard antidepressants.
St. John’s wort is not a completely proven therapy for depression. Though St. John’s wort is considered as a good remedy there have always been inconsistency in the results produced.
Mode of Action
St. John’s Wort works in a similar fashion much like that of Paxil, Zoloft and Prozac, which are well known antidepressants. It elevates the level of a substance called Serotonin, which is a feel-good chemical released by the brain. Specifically, it is believed that the active ingredients hypericin and hyperforin are the key components that contribute to this action. Of the two, hyperforin is considered more significant than hypericin.
Herbal supplements are considered dietary additives, and therefore does not undergo the rigorous testing that major pharmaceuticals do. For this reason, it is important to read the label. The ideal St. John’s Wort supplement should contain a standardized amount of 0.3 percent hypericin and 3 percent hyperforin. The recommended dosage is one 300 mg tablet three times daily.
Side Effects and Contraindications
While St. John’s Wort is generally considered very safe, side effects may occur. These tend to appear when large doses are taken over a long period of time. Dizziness, nausea, sensitivity to sunlight, diarrhea, and fatigue are the common side effects. The side effects can be worse if antidepressants are taken concurrently.
Supplementation should be avoided during pregnancy and breastfeeding. St. John’s Wort can also inhibit and interact with many medications such as indinavir, cyclosporine, theophylline, warfarin and birth control pills. Therefore, St. John’s Wort should not be taken along with these drugs. A physician should be consulted before starting or stopping any type of medication, including herbal preparations.