St. John’s Wort
St. John’s wort (Hypericum perforatum), also known as Klamath weed or goat weed, is a perennial shrubby plant with golden flowers from the botanical family Clusiaceae. Its name comes from the fact that it is traditionally harvested on St.John’s day, June 24. It is used as a herbal remedy for depression, anxiety, and sleep disorders. As it is natural, wholesome, inexpensive, and available over the counter, many people prefer it to taking antidepressiva which are known to have some severe side effects.
St. John’s Wort Clinical Uses
The first records of St. John’s wort as a medicine dates back to the ancient Greeks. Native Americans used it both internally as an abortifacient agent and externally as an antisepctic. In homeopathy, St. John’s wort is used for a number of medical conditions although without scientific evidence regarding success. Today, St. John’s wort is most commonly used as a herbal treatment for depression, anxiety, and sleep disorders. In Germany, for example, St. John’s wort is prescribed far more often than synthetic antidepressants for mild depressive symptoms. While it is still not clear how St. John’s wort works, the active therapeutic ingredients in St. John’s wort are known to be hypericin, pseudohypericin, and xanthones. It is believed that hypericin elevates dopamine and serotonin levels in the brain and that it reduces adrenal activity, an activity which is increased in depression. Although it is a herbal remedy, it can also have side effects, for example, gastrointestinal symptoms, dizziness and tiredness, light-sensitivity, headaches, sexual dysfunctions, and dry mouth. Clinical studies have shown St. John’s wort to be effective in treating minor depressive symptoms, but ineffective in treating major depressions.
St. John’s Wort Dosage and Products
St. John’s wort extract preparations are standardized to contain 0.3 % hypericin. It is recommended that an adult should take 300 miligrams three times per day, which is equivalent to 2.7 miligrams of hypericin per day. St. John’s wort is sold in tablet or capsule form, but also in teabags and tinctures. At large doses, St. John’s wort is poisonous, for instance to grazing livestock.
St. John’s Wort Interaction With Other Drugs
Research has shown that St. John’s wort causes multiple drug interactions by either speeding or slowing a drug’s breakdown. Drugs that are affected include: antidepressants, warfarin and related anticoagulants, birth control pills, digoxin (used to strengthen heart muscle contractions), cyclosporine (taken to prevent the body from rejecting transplanted organs), irinotecan and other cytostatic drugs, indinavir and related drugs used to control HIV infection. Also, patients suffering from lupus erythematosus should not take St. John’s wort. Combined with certain antidepressants, St. John’s wort can increase the side effects, such as nausea, headache, anxiety, and confusion.
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