St. John's Wort

St. John's Wort
St. John's wort has been used for centuries to treat mental disorders and nerve pain.

In ancient times, herbalists wrote about its use as a sedative and a treatment for malaria, as well as a balm for wounds, burns, and insect bites.
Today, St. John's wort is used by some for depression, anxiety, and/or sleep disorders.

How It Is Used
  1. Depression
  2. Mood Fluctuation

What the Science Says
There is some scientific evidence that St. John's wort is useful for treating mild to moderate depression. However, two large studies, one sponsored by NCCAM, showed that the herb was no more effective than placebo in treating major depression of moderate severity.

NCCAM is studying the use of St. John's wort in a wider spectrum of mood disorders, including minor depression.

Side Effects and Cautions
St. John's wort may cause increased sensitivity to sunlight. Other side effects can include anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction.

Research shows that St. John's wort interacts with some drugs. The herb affects the way the body processes or breaks down many drugs; in some cases, it may speed or slow a drug's breakdown.

Drugs that can be affected include:
  • Indinavir and possibly other drugs used to control HIV infection
  • Irinotecan and possibly other drugs used to treat cancer
  • Cyclosporine, which prevents the body from rejecting transplanted organs
  • Digoxin, which strengthens heart muscle contractions
  • Warfarin and related anticoagulants
  • Birth control pills
  • Antidepressants

When combined with certain antidepressants, St. John's wort may increase side effects such as nausea, anxiety, headache, and confusion.


Sources
National Center for Complementary and Alternative Medicine. St. John's Wort and the Treatment of Depression. National Center for Complementary and Alternative Medicine Web site. Accessed June 30, 2005.

St. John's Wort. Natural Medicines Comprehensive Database Web site. Accessed June 30, 2005.

St. John's wort (Hypericum perforatum L.). Natural Standard Database Web site. Accessed June 30, 2005.

St. John's wort. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:359–366.

De Smet PA. Herbal remedies. New England Journal of Medicine. 2002;347(25):2046–2056.

Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St. John's wort) in major depressive disorder: a randomized controlled trial. Journal of the American Medical Association. 2002;287(14):1807–1814.

NCCAM, National Institutes of Health.

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