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St. John's wort

(Known as Hypericum perforatum, Klamathweed)

St. John's wort has a history of medicinal use dating back to ancient Greece, where it was used to treat a range of illnesses. Recent research shows that St. John's wort helps to reduce depressive symptoms in people with mild to moderate (but not severe or major) depression.Studies show that St. John's wort is most valuable for people with mild to moderate, rather than severe depression.St. John's wort grows wild in many different parts of the world. Its name comes from the herb's tendency to flower around the feast of St. John, while a "wort" is the Old English term for a plant. St. John's wort has a long history of use in treating emotional disorders. During the Middle Ages, St. John's wort was popular for "casting out demons," conceivably an archaic description of curing mental illness.

St. John's wort is a prescription antidepressant in Germany, and is more popular than many synthetic drugs as a treatment for depression. When compared with anti-depressants such as imipramine, amitriptyline, doxepin, desipramine, and nortriptyline, St. John's wort works almost as well, but has fewer side effects [1, 3]. In one six-week trial of people with mild to moderate depression comparing St. John's wort to Prozac, St. John's wort was found to be as effective as Prozac, with fewer and less severe side effects [4].

An eight-week study of 263 individuals with moderate depression compared St. John's wort with the antidepressant imipramine [5]. The results show that imipramine and St. John's wort worked equally as well, and both were more effective than placebo. Although scientists are still unsure what the active compound is in St. John's wort that's responsible for its antidepressant effects, studies suggest that it works by inhibiting the reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine [2].

Most studies of St. John's wort shows that it works well for depression of a mild to moderate intensity. St. John's wort should never be relied to treat severe depression. Typical symptoms of mild depression include fatigue and lack of energy, insomnia, feelings of anxiety, appetite disturbance, irritability, difficulty concentrating and an inability to deal with stress.
The usual dose for mild to moderate depression is 150 to 175 milligrams (standardised to 0.3% hypericin extract) three times per day, with meals. We recommend the Solgar brand of St. John's Wort.Improvements in mood are often noted as early as two weeks, although it can take up to six weeks for some people to experience a significant benefit.St. John's wort interacts with a wide variety of medications, and should be used under the guidance of a suitably qualified health professional.

1. Ernst E, Rand JI, Barnes J, Stevinson C. (1998). Adverse effects profile of the herbal antidepressant St. John's wort (Hypericum perforatum L.) European Journal of Clinical Pharmacology, 54, 589-594
2. Muller WE, Rolli M, Schafer C, Hafner U. (1997). Effects of hypericum extract (LI 160) in biochemical models of antidepressant activity. Pharmacopsychiatry, S30,102-107
3. Woelk H (2000). Comparison of St John's wort and imipramine for treating depression: randomised controlled trial. British Medical Journal, 321, 536-539
4. Schrader E. (2000). Equivalence of St John's wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression. International Clinical Psychopharmacology, 15, 61-68
5. Philipp M, Kohnen R, Hiller KO. (1999). Hypericum extract versus imipramine or placebo in patients with moderate depression: randomised multicentre study of treatment for eight weeks. British Medical Journal, 319, 1534-1539

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