ST. JOHN’S WORT AND TREATMENT OF DEPRESSION

INTRODUCTION: One of the most popular herbs in the United States, St. John’s wort (Hypericum perforatum), is found growing throughout Asia, Europe, and North America. Its modern use is as an antidepressant. It gets its name from a legend that red spots once appeared on its leaves on the anniversary of the beheading of St. John the Baptist. The word wort is a British term for “plant.”

ACTIVE INGREDIENTS: The primary active ingredients found in St. John’s wort are hypericin and hyperforin, which are believed to selectively inhibit serotonin reuptake in certain brain neurons. A number of clinical studies suggest that St. John’s wort is an effective treatment for mild to moderate depression, that it may be just as effective as standard antidepressants, and that it causes fewer adverse effects than traditional drugs.

DRUG-DRUG INTERACTIONS: St. John’s wort, however, may interact with many medications, including hormonal contraceptives, warfarin, digoxin, and cyclosporine. It should not be taken concurrently with antidepressant medications. St. John’s wort is well tolerated, producing mild side effects such as GI distress, fatigue, and allergic skin reactions. The herb contains compounds that photosensitize the skin; thus, patients should be advised to apply sunscreen or to wear protective clothing when outdoors.

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