Millions of people have tried St. John's wort, an herbal remedy, as an alternative or natural treatment for depression. Is it effective?
St. John’s Wort and Depression
What is a dietary supplement?
The FDA says dietary supplements include herbs such as St John's wort, vitamins, minerals, and amino acids. They come in various forms such as pills, liquids, and powders and are intended to supplement your diet. The FDA doesn't regulate supplements in the same way as medications.
Many studies have examined how well St. John's wort works. Some studies show a benefit, but others do not.
Before using St. John's wort, be sure to learn all you can about it and check with your doctor. St. John's wort can interact with medicines or other supplements and may have side effects.
What evidence is there for St. John’s wort and depression?
There is some scientific evidence that St. John's wort may help treat mild depression, with benefits similar to those of antidepressants. But two large studies, one sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), showed that the herb wasn't more effective than a placebo in treating moderately severe major depression. Conventional drugs tested in these studies also didn't fare any better than a placebo.
What brands can I trust for St. John’s wort and depression?
Only buy products that list the herb's common and scientific name, the name and address of the manufacturer, a batch and lot number, expiration date, dosage guidelines, and potential side effects.
How to Take St. John’s Wort for Depression
You'll probably take St. John's wort as a liquid or capsule or use the dried herb to make tea.
The most common dose used in studies has been 300 milligrams, three times a day, as a standardized extract. Preparations in the U.S. have varied amounts, so be careful to note how much you're getting.
Things to keep in mind when taking St. John’s wort for depression
Don't combine St John's wort and prescription antidepressants such as selective serotonin reuptake inhibitors (SSRIs). That can result in too much serotonin, a condition called serotonin syndrome. You may have to wait for a certain period before you start St. John's wort, even if you and your doctor decide to stop taking an antidepressant. (Don't stop taking an antidepressant on your own.)
Avoid foods or drinks that contain a chemical called tyramine. These items include aged cheeses, cured meats, sauerkraut, soy sauce, miso, tofu, beer, and wine. Some research shows that when St. John's wort mixes with tyramine, it can lead to serious problems, including high blood pressure, fast heart rate, and becoming delirious.
Doctors don't suggest herbal remedies for pregnant women, children, older adults, people with certain medical conditions, or those taking certain medicines.
Research from the National Institutes of Health shows that St. John's wort may affect how well some drugs work; these include birth control pills, drugs used to prevent organ transplant rejections, and some heart disease medications. Talk to your doctor about all the medicines you take.
If you have side effects such as nausea, vomiting, rapid heartbeat, anxiety, insomnia, diarrhea, or skin rashes, stop taking St. John's wort and tell your doctor.
Beware of commercial claims of what St. John's wort can do. Look for scientific-based sources of information.
Risks of St. John’s Wort for Depression
You should be alert for any of the following effects:
- Allergic reactions
- Fatigue and restlessness
- Higher blood pressure
- More sensitivity to the sun, especially if you are fair-skinned and take large doses
- Upset stomach
Takeaways
St. John's wort is a herbal supplement often used for mild depression, but you should be careful when taking it. Some studies show it works like antidepressants, but others found it isn't better than a placebo for serious depression. St. John's wort can interact with many medications, such as birth control pills, HIV medicines, and heart or transplant drugs, making them less effective. Mixing it with certain foods or drugs can also cause dangerous side effects such as serotonin syndrome or high blood pressure. Always check with your doctor before using St. John's wort, especially if you take other medications, and watch for side effects such as nausea, skin reactions, or allergies.
