St. John's Wort For Treatment of Depression

Written by National Center for Complementary and Alternative Medicine

Detailed information on St. John's Wort, an alternative herbal treatment for depression, including dangerous interactions between St. John's Wort and certain medications.

Contents

• Introduction
• Key Points
• Frequently Asked Questions
• For More Information
• Selected Sources

Introduction

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The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet on the use of St. John's wort for depression. It is part of a series intended to help consumers make informed decisions about whether to use complementary and alternative medicine (CAM) for a disease or medical condition. NCCAM defines CAM as approaches to health care that are not currently part of conventional medicine as practiced in the United States.^a

Key Points

• St. John's wort is an herb that has been used for centuries for medicinal purposes, including to treat depression.

• The composition of St. John's wort and how it might work are not well understood.

• There is some scientific evidence that St. John's wort is useful for treating mild to moderate depression. However, recent studies suggest that St. John's wort is of no benefit in treating major depression of moderate severity. More research is required to help us know whether St. John's wort has value in treating other forms of depression.

• St. John's wort interacts with certain drugs, and these interactions can be dangerous.

• It is important to inform all of your health care providers about any therapy that you are currently using or considering, including any dietary supplements. This is to help ensure a safe and coordinated course of care.

^a Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. To find out more, see the NCCAM fact sheet "What Is Complementary and Alternative Medicine?"

Frequently Asked Questions

1. What is St. John's wort?
St. John's wort (Hypericum perforatum in Latin) is a long-living plant with yellow flowers. It contains many chemical compounds. Some are believed to be the active ingredients that produce the herb's effects, including the compounds hypericin and hyperforin.

How these compounds actually work in the body is not yet known, but several theories have been suggested. Preliminary studies suggest that St. John's wort might work by preventing nerve cells in the brain from reabsorbing the chemical messenger serotonin, or by reducing levels of a protein involved in the body's immune system functioning.

2. For what medicinal purposes has St. John's wort been used?
St. John's wort has been used for centuries to treat mental disorders as well as nerve pain. In ancient times, doctors and herbalists (specialists in herbs) wrote about its use as a sedative and treatment for malaria as well as a balm for wounds, burns, and insect bites. Today, St. John's wort is used by some people to treat mild to moderate depression, anxiety, or sleep disorders.

3. What is depression?
Information on depression is available from the National Institute of Mental Health. Here is a brief overview.

Depression is a medical condition that affects nearly 19 million Americans each year. A person's mood, thoughts, physical health, and behavior all may be affected. Symptoms commonly include:

• Ongoing sad mood
• Loss of interest or pleasure in activities that the person once enjoyed
• Significant change in appetite or weight
• Oversleeping or difficulty sleeping
• Agitation or unusual slowness
• Loss of energy
• Feelings of worthlessness or guilt
• Difficulty "thinking," such as concentrating or making decisions
• Recurrent thoughts of death or suicide