St Johns Wort
Background
St.
John’s wort is a plant with yellow flowers that has been used in
traditional European medicine as far back as the ancient Greeks. The
name St. John’s wort apparently refers to John the Baptist, as the
plant blooms around the time of the feast of St. John the Baptist in
late June.
Historically, St. John’s wort has been used for a
variety of conditions, including kidney and lung ailments, insomnia,
and depression, and to aid wound healing.
Currently, St. John’s
wort is most often used as a dietary supplement for depression. People
also use it as a dietary supplement for other conditions, including
menopausal symptoms, attention-deficit hyperactivity disorder (ADHD),
and obsessive-compulsive disorder. It is used topically for
wound healing.
The flowering tops of St. John’s wort are used
to prepare teas, tablets, capsules, and liquid extracts. Topical
preparations are also available.
How Much Do We Know?
There
has been extensive research on St. John’s wort, especially on its use
for depression and on its interactions with medications.
It
has been clearly shown that St. John’s wort can interact in dangerous,
sometimes life-threatening ways with a variety of medicines.
What Have We Learned?
The
results of studies on the effectiveness of St. John’s wort for
depression are mixed. For more information, see the NCCIH fact sheet
St. John’s Wort and Depression.
St.
John’s wort has also been studied for conditions other than depression.
For some, such as ADHD, irritable bowel syndrome, and quitting smoking,
current evidence indicates that St. John’s wort is not helpful. For
others, such as menopausal symptoms, premenstrual syndrome, and
obsessive-compulsive disorder, the evidence is inconclusive.
What Do We Know About Safety?
St. John’s wort can
weaken the effects of many medicines, including crucially important
medicines such
as
Antidepressants
Birth control pills
Cyclosporine, which prevents the body from rejecting
transplanted organs
Digoxin, a heart medication
Some HIV drugs including indinavir
Some cancer medications including irinotecan
Warfarin, an anticoagulant (blood thinner).
Taking
St. John’s wort with certain antidepressants or other drugs that affect
serotonin, a substance produced by nerve cells, may lead to increased
serotonin-related side effects, which may be
potentially serious.
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.
Keep in Mind
Depression can be a serious illness. If you or someone in your family
may have depression, consult a health care provider.
Although
it is important to tell all your health care providers about any
complementary health approaches you use, this is especially crucial for
St. John’s wort because this herb interacts with so many medicines.
Interactions with St. John’s wort
can weaken the effects of lifesaving medicines or cause dangerous
side effects.
Key References
- Cott
JM. St. John’s wort. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary
Supplements. 2nd
ed. New York, NY: Informa Healthcare; 2010:727-737.
- Borrelli
F, Izzo AA. Herb-drug
interactions with St. John’s wort (Hypericum perforatum):
an update on clinical observations. The AAPS Journal. 2009;11(4):2009;11(4):710-727.
- Gurley
BJ, Fifer EK, Gardner Z. Pharmacokinetic
herb-drug interactions (part 2): drug interactions involving popular
botanical dietary supplements and their clinical relevance. Planta Medica. 2012;78(13):1490-1514.
- Linde
K, Berner MM, Kriston L. St. John’s wort for major depression. Cochrane Database of Systematic
Reviews. 2008;(4):CD000448
[edited 2009]. Accessed at http://www.thecochranelibrary.com(link
is external) on
April 27, 2015.
- Parsons
A, Ingram J, Inglis J, et al. A
proof of concept randomised placebo controlled factorial trial to
examine the efficacy of St. John’s wort for smoking cessation and
chromium to prevent weight gain on smoking cessation. Drug and Alcohol Dependence. 2009;102(1-3):116-122.
- Rapaport
MH, Nierenberg AA, Howland R, et al. The
treatment of minor depression with St. John’s wort or citalopram:
failure to show benefit over placebo. Journal of Psychiatric Research. 2011;45(7):931-941.
- Saito
YA, Rey E, Almazar-Elder AE, et al. A
randomized, double-blind, placebo-controlled trial of St. John’s wort
for treating irritable bowel syndrome. American Journal of
Gastroenterology. 2010;105(1):170-177.
- Sarris
J, Fava M, Schweitzer I, et al. St
John’s wort (Hypericum perforatum) versus
sertraline and placebo in major depressive disorder: continuation data
from a 26-week RCT. Pharmacopsychiatry. 2012;45(7):275-278.
- Sood
A, Ebbert JO, Prasad K, et al. A
randomized clinical trial of St. John’s wort for smoking cessation. Journal of Alternative and
Complementary Medicine. 2010;16(7):761-767.
- St.
John’s wort. In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded
Commission E Monographs. Newton,
MA: Integrative Medicine Communications; 2000:359-366.
- St.
John’s wort. Natural Medicines Web site. Accessed at
naturalmedicines.therapeuticresearch.com on April 27, 2015.
[Database subscription].
- Weber
W, Vander Stoep A, McCarty RL, et al. Hypericum perforatum (St.
John’s wort) for attention-deficit/hyperactivity disorder in children
and adolescents: a randomized controlled trial. JAMA. 2008;299(22):2633-2641.
-NIH
