St John’s wort (hypericum) is a short, yellow-flowering, wild-growing plant native to all parts of Britain and the majority of mainland Europe, western Asia and North Africa, growing prolifically in these areas. The name St. John probably refers to John the Baptist, whom tradition said was born on the summer solstice. It was claimed that the red spots visible on the underside of some of the herb’s leaves symbolised the blood of St. John, who was beheaded by Herod.

Hypericum has been used for centuries as a medicinal herb. The renowned Greek herbalists of the 1st century – Pliny, Discorides and Hippocrates – all used this herb, while the ancient Greek scholar, Galen, described it as ‘the antidote to intestinal worms.’ Today the herb St John’s wort is made into capsules and other types of preparations and it has recently become an extremely popular natural treatment for depression.

How does hypericum work?

St John’s wort contains many different substances. Some are thought to be the active ingredients. How these chemicals actually work in the body is not clear. It is thought that they may alter the balance of some of the chemicals in the brain (neurotransmitters) such as serotonin, dopamine, and gamma aminobutyric acid (GABA). Alterations in the balance of these neurotransmitters are thought to play some part in causing depression.

How effective is St John’s wort?

In Germany, where the majority of clinical research has been conducted, it is prescribed 50% of the time for mild to moderate depression. In comparison, Prozac is only prescribed 2% of the time; In the British Journal of Medicine twenty-three separate clinical trials have been published concerning Hypericum; And in the United States, the National Institute of Mental Health (NIMH) is planning studies of its own. The general consensus seems to be that Hypericum is a promising treatment for mild to moderate depression. However for severe depression and cases of bipolar disorder Hypericum is not considered effective.

How quickly does St John’s wort work?

Findings suggest that 900 mg of St. John’s wort (450 mg two times daily or 300 mg three times daily) is needed to reduce symptoms of depression. Like prescription antidepressants, it takes 2-4 weeks for the effect of St John’s wort to build up fully.

Is it safe?

Some reported side effects from St John’s wort have been dry mouth, dizziness and increased sensitivity to sunlight.

St John’s wort should be taken with care if you are already on medication. So you should not take it if you are taking warfarin, cyclosporin, oral contraceptives, anticonvulsants, digoxin, theophylline, or certain anti-HIV drugs. This is because it may reduce the effect of these drugs. You should not take it at the same time as taking an SSRI antidepressant (selective serotonin reuptake inhibitor) or a triptan drugs used for migraine (such as sumatriptan). Also, you should not take St John’s wort if you are pregnant or breastfeeding as it has not been proved to be safe in these situations.

The bottom line:

Hypericum is suitable for boosting mood and calming those who are anxious, but it should not be used for anything more than mild to moderate depression or states of anxiety.

(I use a good one in the clinic which contains around 300mg per capsule).

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