Using for Depression and Anxiety

Isn’t all St. John’s wort the same?
No, recently published clinical research has shown that Hyperforin is the main active ingredient in St. John’s wort thought responsible for treating the symptoms of depression and anxiety.

What should I look for when buying St. John’s wort?
Look for products standardized to contain at least 3% hyperforin. This ensures you are taking the proven concentration demonstrated in scientific studies. A standard daily dose of 900mg of St. John’s wort extract should contain at least 27mg of hyperforin. Also check to see that the color of the bottle is dark. Since hyperforin is sensitive to heat and light, the St. John’s wort may degrade sooner in a white or clear bottle.

What is the recommended daily dose for St. John’s wort?
The daily recommended dose for St. John’s wort is 900 mg per day. For 300mg capsules, take one capsule 3x daily. For 450mg capsules, take one capsule twice daily.

How long should I be taking St. John’s wort before expecting results?
St. John’s wort usually takes about a month to start working, and research shows that it doesn’t reach maximum effect for 6-8 weeks. So generally, you should take St. John’s wort for about two months before expecting results. (Some people, however, see benefits after just a couple weeks.)

Are there any side effects to using St. John’s wort? If so, what kind of side effects may I possibly experience?
Most users of St. John’s wort do not experience side effects. As with any medicine, however, a small percentage of users may experience side effects. The most common side effects associated with St. John’s use are headaches, upset stomach, fatigue, vivid or unusual dreams, photosensitivity and possible initial increase in anxiety. St. John’s wort side effects usually tend to be mild when compared to prescription antidepressants’ side effects. They usually go away in a few weeks on their own. Since side effects are almost always mild and temporary, in general you shouldn’t worry about side effects when deciding whether to take St. John’s wort.

Are there any possible drug interactions with St. John’s wort?
Yes, there may be possible drug-herbal interactions while using St. John’s wort. St. John’s wort affects the same liver enzymes that metabolize over 50% of the available prescription and OTC drugs that are currently sold in the market. If you’re taking prescription medication, consult with your doctor to ensure that your current drug regimen will not interact adversely with St. John’s wort.

St. John’s wort may interact negatively with SSRIs, SNRIs, tricyclics or other antidepressants. The combination of St. John’s wort with these antidepressant drugs may cause a potentially serious condition called “Serotonin Syndrome”, which occurs when there is too much serotonin activity in the system. For most people, St. John’s wort can be safely taken with these drugs, but because there is a real potential for a negative reaction, it’s important to consult with your doctor before taking St. John’s wort if you’re on a prescription antidepressant. If you wish to wean off prescription antidepressants and switch to using St. John’s wort, you’re doctor can help you do this safely.

People who are taking MAO inhibitors should absolutely not take St. John’s wort for at least 14 days after they have stopped taking MAO inhibitors. Please consult with your prescribing doctor for more information.

Special note: Women on oral contraceptives should consult with GYN doctors prior to starting St. John’s wort. St. John’s wort can significantly lower the effectiveness of oral birth control.

Possible contraindications or precautions to using St. John’s wort

Can St. John’s wort be used for severe depression?
St. John’s wort has over 27 published clinical studies proving its efficacy in treating the symptoms of mild-to-moderate depression. At this time, there are not enough studies to definitively conclude that St. John’s wort is effective for treatment of severe depression. One study did find St. John’s wort to be more effective than a prescription antidepressant for moderate-to-severe depression, however, so it does seem that St. John’s wort may have potential even for severe cases. That said, severely depressed individuals who may be suicidal should not take St. John’s wort at this time and should seek immediate medical attention.

Can St. John’s wort be used to treat bipolar disorder?
St. John’s wort is not recommended for people who have been diagnosed or currently undergoing treatment for bipolar disorder. St. John’s wort is a mood uplifter, which may possibly worsen mania in susceptible individuals.

Can St. John’s wort be used by women who are nursing, currently pregnant or planning to get pregnant?
St. John’s wort is not recommended for pregnant, nursing or women who are planning to get pregnant, since there is not enough safety data of St. John’s wort in this patient population. Please consult with your OB/GYN doctor for more information on the safety of using St. John’s wort while nursing or during pregnancy.

Can St. John’s wort be used by children?
St. John’s wort can be used by children aged 12 years old and up under parental supervision. However, there is not enough data to establish safety for use in children under 12 years old. Please consult with your child’s pediatrician for more information about St. John’s wort.

Who else shouldn’t take St. John’s wort?
People with chronic or serious health conditions, including schizophrenia and seizures, should consult with their doctors prior to starting St. John’s wort.