St. John's wort

St. John's wort (Hypericum perforatum) has a history of use as a medicine dating back to ancient Greece, where it was used for a range of illnesses, including various nervous disorders. St. John's wort also has antibacterial, antioxidant, and antiviral properties. Because of its anti-inflammatory properties, it has been applied to the skin to help heal wounds and burns. St. John's wort is one of the most commonly purchased herbal products in the United States.

In recent years, St. John's wort has been studied extensively as a treatment for depression. Most studies show that St. John's wort may help treat mild-to-moderate depression, and has fewer side effects than most other prescription antidepressants. But it interacts with a number of medications, so it should be taken only under the guidance of a health care provider.

DO NOT use herbs to treat severe depression -- where you have trouble functioning day to day, or have thoughts of harming yourself or others. Always see a doctor if your depression is making it hard for you to function (See "Precautions" section).

Depression

There is good evidence that St. John's wort may reduce symptoms in people with mild-to-moderate, but not severe (or major) depression. In many studies it seems to work as well as selective serotonin reuptake inhibitors (SSRIs), a popular type of antidepressant often prescribed to treat depression. SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). In addition, St. John's wort doesn't seem to cause loss of sex drive, one of the most common side effects of antidepressants.

St. John's wort contains several chemicals, including hypericin, hyperforin, and flavonoids. Researchers aren't exactly sure how St. John's wort works. Some have suggested that the herb acts similar to an SSRI, increasing the availability of the brain chemicals serotonin, dopamine, and norepinephrine. These neurotransmitters help improve mood. Scientists thought that hypericin was responsible, but now they believe that other chemicals in St. John's wort may help.

Not all studies agree, however. In one study, St. John's wort was found to be no more effective than placebo for treating depression. But these studies should be weighed against the majority that have found St. John's wort helps depression. For example, in the same study, Zoloft also failed to show any benefit in treating depression. Many other studies have compared St. John's wort to Prozac, Celexa, paroxetine (Paxil), and Zoloft, and found that the herb works as well as the drugs. Other studies are ongoing.

Other Uses

St. John's wort has also shown promise in treating the following conditions, a few of which are related to depression.

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Alcoholism Burns Depression Viral encephalitis Hemorrhoids HIV and AIDS Otitis media Premenstrual syndrome Wounds

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Herbal medicine

Review Date: 1/1/2017  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.

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