Treating Depression with St. Johns Wort

Clinical Studies Support Hypericum Extract Regulation and Use

Mar 4, 2009 Alicia Mae Prater

The extract of Hypericum plants has been used for centuries in alternative medicine, but how trustworthy are anecdotes for treating depression?

St. John’s wort is known by the scientific name Hypericum perforatum L. and is a member of the Hypericaceae family. The plant is listed as a noxious weed in nine U.S. states and is considered a livestock-poisoning plant, but its extract is sold as an herbal supplement for depression and not currently regulated by the Food and Drug Administration (FDA). Research on the plant is relatively unknown.

Facts about St. John’s Wort

Hypericum plants are native to Northern Africa, parts of Asia, and Europe. The plant has been naturalized to Japan, Australia, South America, the West Indies, and parts of North America, including Hawaii. The plants are usually collected when flowering because the distinctive yellow flower is considered the most advantageous portion of the plant.

St. John’s wort supplements are found in many forms, such as teas, pills, and capsules, and for many indications, the most well-known being depression. The active chemicals in the extract are hypericin and hyperforin.

Studies of the Effect of Hypericum Extract on Depression

In 1997, a Swedish study looking at 25 controlled trials found that treating depression with a low dose of extract improved the moods of 61 percent of patients, and high doses (2.7 mg) improved 75 percent of patients. They also found that side effects were mild and less frequent than with other antidepressants (study abstract translation available here).

More recent studies have found that the possible mechanism of action may involve the serotonin, dopamine, and adrenaline pathways, but it seems to have only a weak effect on monoamine oxidase A and B activity, the assumed pathway 15 to 20 years ago. The GABAergic pathway has also been shown to be affected, and there is some indication that it exerts genetic control over the stress axis.

There are still many questions about the exact mechanisms of Hypericum in treating depression, but there does appear to be evidence that it works, both anecdotal and clinical. There is a need for more comparative studies with highly prescribed antidepressants, such as fluoxetine, in order to bring this supplement under regulation and make it safely available to the patients. One review in 2001 even suggested it be used in the treatment of clinical depression.

Side Effects of St John’s Wort Supplements

There are a few effects that must be noted for this herbal supplement:

• Photosensitivity - The molecular reactions of hypericin causes increased sensitivity to UV light. There are also concerns about the effect this may have on the retina, and blindness is a possibility for those who take high doses of the extract for long periods of time and are exposed to sunlight.
• Drug-drug interactions - Hypericin interferes with antibiotics, antiviral medications, and birth control.
• No regulation and heavy metal poisoning - Because herbal and dietary supplements are not regulated, there have been many cases of heavy metal poisoning due to negligence during manufacturing. This is not a side effect of the plant itself, but a call for more strict production regulation.

Additional References

Butterweck (2003) Mechanism of action of St John's wort in depression: what is known? CNS Drugs. 17: 539-562.

Carlo et al. (2001) St John’s wort: Prozac from the plant kingdom. Trends in Pharmacological Sciences. 22: 292-297.

Southern Illinois University website, ethnobotanical leaflets

Agin. Junk Science. 2006. Thomas Dunne Books, New York.

The copyright of the article Treating Depression with St. Johns Wort in Natural Medicine is owned by Alicia Mae Prater. Permission to republish Treating Depression with St. Johns Wort in print or online must be granted by the author in writing.

Hypericum perforatum

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Mar 31, 2009 3:55 PM

Guest :

I suffered from depression and a Post Traumatic Stress Disorder. I never liked the medicine I got: one made me so stiff, I lost all fun in movement while gaining 20 kg. Animal testing was another concern of mine but felt my child to whom I lashed out too often, mattered more. I turned my back on psychology after being reduced to a statistic, apparently I was expected to return to to where I never should have been. In my mind as in my environment. Once I fitted with the others who walked a less defiant path, I would be happy. But all my life I had been there and tried to be a nice, compliant one. All the while feeling like I wasn't who I supposed to be. I gotten interested in herbalism, something my former environment frowned upon. It took me lots of time and with a better support(system)it would not have taken me this long.
There's a lot of anger left, but feel confident I will not lash out to strangers who have nothing to do with that. I switched to St. John Worth a few months ago to battle depressive moods(not as bad as before since it has been some time ago) and Valerian to battle the stress symptoms , both as tea. I now make major steps ahead in combating the disorders and proceeding forth in my life. Peace and progression have returned and to both of us, it took away the dark cloth that hid us for so long.

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