St. John’s Wort for Depression – Research Review & How It Works

The use of St. John’s wort for depression is purported to improve mood and support balance of the brain chemicals dopamine and serotonin.

In 29 international research studies, this herbal supplement was found to be more effective than a placebo and as effective as standard medications used to treat mild to moderate cases of major depression.

Furthermore, the supplement decreased symptoms with a lower risk of side effects compared to standard prescription antidepressants.

However, in two studies sponsored by NCCIH and the National Institute of Mental Health, St. John’s wort was not more effective than a placebo for the treatment of depression.

Consumers who want to take St. John’s wort for depression should understand the risks that are associated with it. They should also know how this herb works, how to use it and when to consider taking it.

Although St. John’s wort is generally safe, there are some side effects and potential drug interactions that consumers should be aware of before using it.

St. John's Wort

Herbal Supplement

Mood

Calm

Sleep

How It Works:

• Clinically studied to reduce feelings of depression
• Natural mood enhancer & calming agent
• Supports healthy sleep patterns

Dosage:

Between 300 - 900 per day

Safety:

Rated Likely Safe; Interacts with Several Drugs

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Benefits of St. John’s Wort for Depression

St. John’s wort, or Hypericum perforatum, is a plant with flowers and leaves that have been used for medicinal purposes for centuries.

In fact, it was used for managing nervous disorders in ancient Greece, according to the University of Maryland Medical Center. [1]

St. John’s wort has anti-inflammatory, antiviral and antibacterial properties, and it also acts as an antioxidant that reduces damage to cells. This plant contains certain chemicals, such as hypericin, that researchers have studied for their effects on depression.

St. John’s wort is used as a natural remedy for managing some types of depression. These include mild-to-moderate or low-level depression, seasonal affective disorder, major depression and mood changes that are associated with menopause.

It is also used for anxiety and some symptoms that are associated with depression, such as appetite loss, fatigue and insomnia.

Although researchers do not fully understand St. John’s wort’s mechanism of action for managing depression, some of the constituents that are thought to be active include flavonoids, amino acids, hyperforin, hypericin and xanthones, according to the Natural Medicines Comprehensive Database. [2]

Some researchers have theorized that St. John’s wort helps regulate the levels of brain chemicals that elevate mood, such as serotonin, norepinephrine and dopamine, according to the University of Maryland Medical Center. [1]

Does St. John’s wort work for depression? A 2008 review of St. John’s wort for depression that was published in the Cochrane Database of Systematic Reviews found that hypericin extracts of this herb were more effective than a placebo for subjects with major depression that was mild to moderate in severity.

It also found that St. John’s wort extracts had a similar effectiveness as standard types of antidepressants and produced fewer side effects. [3]

The Natural Medicines Comprehensive Database states that the efficacy of St. John’s wort for major depression is considered questionable due to the results of studies done in psychiatric care settings.

However, studies involving subjects in primary care settings rather than psychiatric care settings have shown that St. John’s wort is effective at managing depression in most patients. [2]

Despite this, St. John’s wort has not been approved by the FDA in the United States as a drug for the treatment of depression or any other mood disorder.

How to Take St. John’s Wort for Depression

St. John’s wort is available in different forms for oral use in patients with depression, including tablets, tea, capsules, powder and tinctures. Many of these products contain 0.3 percent hypericin, according to the University of Maryland Medical Center. [1]

There is no standard dosage of St. John’s wort for low-level depression or major depression. You should consult with a doctor before using this herb for the treatment of any medical condition.

The typical dose for adults with depression is 300 MG, according to the University of Maryland Medical Center. [1] However, this dosage might vary from one individual to another based on age, health and other factors.

Those who use it should note that it can take up to 6 weeks for effects of this herb to begin showing. Consumers should not stop using St. John’s wort suddenly due to the risk of side effects. Instead, dosages should gradually be lowered.

Consumers should ask their doctor about appropriate dosages of St. John’s wort for depression. Do not use this supplement to replace a conventional care doctor without first consult with a qualified health care provider who knows your medical history.

Side Effects of St. John’s Wort Supplements

Many consumers prefer to use St. John’s wort to alleviate their depression symptoms due to the lower risk of side effects that this supplement poses compared to prescription anti-depressant medications.

However, there are some negative effects that can occur when taking this supplement, especially if using it in conjunction with other pharmaceutical agents.

According to the Natural Medicines Comprehensive Database, St. John’s wort is considered likely safe for oral use when taken for up to 12 weeks, but it is possibly unsafe when it is used in large doses, such as 2 to 4 grams daily. [2]

Larger doses might increase the risk of photosensitivity. Other side effects that can occur with the use of St. John’s wort include skin reactions, gastrointestinal problems, restlessness and fatigue.

St. John’s wort is possibly safe for pediatric use, but it should not be given to children without consulting a doctor. The Natural Comprehensive Database states that pregnant women and women who are lactating should avoid taking St. John’s wort. [2]

Oral extracts of this herb might increase the risk of colic, lethargy and drowsiness in infants who breastfeed. Findings on the safety of St. John’s wort during pregnancy have been contradictory.

The use of St. John’s wort pills for depression and anxiety has the potential to interact with certain types of medication.

The National Center for Complementary and Integrative Health states that using St. John’s wort and some antidepressants can increase serotonin levels to dangerous levels. [4]

This condition, known as serotonin syndrome, can cause confusion and other symptoms and potentially be fatal. Those who take antidepressants should not use St. John’s wort without talking to their doctor.

St. John’s wort might also reduce the efficacy of certain medications, such as birth control pills, blood thinners, digoxin, cyclosporine and some cancer medications, according to the National Center for Complementary and Integrative Health. [4]

Those who use these medications should consult their doctor before using St. John’s wort to reduce the risk of side effects.

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