St. John's Wort

St. John's Wort

St. John's Wort
St. John’s Wort, a yellow flowering plant, is a popular herbal treatment for depression. This natural remedy has been known to treat symptoms of depression for centuries. St. John’s Wort supplement is available in pill or liquid. As with any alternative medicines please consult your health provider for treatment, correct dosage, benefits and risk factors.

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    A , Healthcare, answered
    St. John’s wort (Hypericum perforatum), the popular herbal remedy used to lift symptoms of depression, is taken by more than 20 million Germans on a daily basis and has become quite popular in the United States. This herbal supplement is taken internally to relieve depression without the side effects of prescription antidepressants. In a study published in the British Journal of Obstetrics and Gynaecology, researchers report that St. John’s wort may help women with PMS (premenstrual syndrome) by easing nervous tension, anxiety, and insomnia.

    In a four-month study, 19 women with PMS kept track of their daily symptoms and took psychological tests to rate their emotions and physical state. During months three and four, women were given 300 milligrams of hypericin, the active ingredient in St. John’s wort, and continued to chart their symptoms. Treatment with St. John's wort for two menstrual cycles resulted in significant improvements in PMS symptoms, with greatly reduced symptoms, such as nervous tension, insomnia, crying and depression.

    St. John’s Wort is available as capsules, tincture, extract, oil, and dried leaves and flowers.  St. John’s Wort can cause sensitive skin in sunlight. Moreover, because this herb can interact with prescription medications, talk to your doctor before self-medicating. (Caution: Since the mechanism of action of St John wort is uncertain, using it with antidepressants such as monoamine oxidase inhibitors and selective serotonin reuptake inhibitors is not advised. Pregnant women are advised not to take St. Johns wort.)
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    A , Naturopathic Medicine, answered
    Dr. Peter Bongiorno - What should I know before using St. John's Wort?

    Naturopathic Doctor and Licensed Acupuncturist Dr. Peter Bongiorno discusses what you should know before using St. John's Wort as an herbal remedy. Watch Dr. Peter Bongiorno's video for tips on naturopathic remedies and alternative treatments.


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    A , Pharmacy, answered
    St. John's wort is likely to be effective in treating mild to moderate depression. It has been shown to improve mood and to reduce anxiety, insomnia and physical symptoms related to depression. Guidelines from the American College of Physicians-American Society of Internal Medicine call it an option for short-term treatment of mild depression, but note that evidence is limited and products are not regulated.

    On the other hand, St. John's wort can interact with a long list of drugs. And since there's no evidence that it's more effective than conventional antidepressants or tolerated significantly better, it may not be your best choice, especially if you take other medications. Some evidence suggests that St. John's wort may be less effective in treating severe depression than it is for milder cases.
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    If you have any sort of heart condition, be sure to check with your doctor before you take St. John's wort. Although people sometimes take St. John's wort to treat heart palpitations, there is not enough evidence yet to know whether it's effective. But it's well known that the herb can interact dangerously with a large number of drugs, including several that people take to treat heart conditions, such as digoxin (Lanoxin), warfarin (Coumadin), clopidogrel (Plavix) and some channel blockers.
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    A , Pharmacy, answered
    Using St. John's Wort in various cultural and traditional environments may be different from approaches accepted by present day Western medicine. When you are determining whether to use any herbal supplement, such as St. John's Wort, discussion about it with your doctor is recommended because of its possible serious interactions with prescription medicines you are taking and health issues you may have. In addition, you may benefit from a discussion with a practitioner specifically trained in herbal supplements.

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    A , Pharmacy, answered

    Store St. John's Wort at room temperature. Keep the product in a container that is shut from heat, moisture and light unless stated differently on the package label. Avoid storing it in the bathroom, near a sink or in damp location, since moisture can cause it to break down and not work properly. Make sure the product is not accessible to children, especially since most herbal products do not come in childproof containers. Do not keep medication that is outdated or not needed any longer.

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    St. John's wort is widely known as an herbal medicine for treating depression but, as with other supplements, it can have side effects. The most common reported are gastrointestinal symptoms, dizziness, confusion, tiredness and sedation. It should not be taken by women on contraceptive medication because of problems that can be caused in the liver. Those diagnosed with schizophrenia should avoid taking St. John's wort since it has been found to cause psychosis in these patients. St. John's wort interferes with birth control pills by decreasing their effectiveness. It also does that with cyclosporin used to prevent rejection of transplants. 
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    A answered
    St. John's wort is one of the better-studied herbs because of its reported effectiveness; it has also been found to interact with a large number of drugs. St. John’s wort makes some drugs stronger, others weaker. It should not be used if you are taking the following:

    abiraterone; aliskiren; almotriptan; alprazolam; amiodarone; amitriptyline; amoxapine; apixaban; apremilast; aprepitant; atazanavir; avanafil; axitinib; bedaquiline; bexarotene; boceprevir; bortezomib; bosutinib; cabozantinib; calcitriol; cariprazine; ceritinib; cholecalciferol; citalopram; clarithromycin; clomipramine; clopidogrel; cobicistat; cobimetinib; crizotinib; cyclosporine; dabigatran etexilate; dabrafenib; daclatasvir; darunavir; dasatinib; delavirdine; desipramine; desogestrel; dextromethorphan; diazepam; dienogest; digoxin; diltiazem; docetaxel; dolutegravir; doxepin; doxercalciferol; dronedarone; drospirenone; edoxaban; efavirenz; elbasvir; eletriptan; eliglustat; elvitegravir; enzalutamide; erlotinib; escitalopram; esomeprazole; estradiol; ethinyl estradiol; ethynodiol; etonogestrel; etravirine; everolimus; exemestane; fexofenadine; finasteride; flibanserin; fluoxetine; fluvoxamine; fosamprenavir; fosaprepitant; frovatriptan; grazoprevir; ibrutinib; idelalisib; ifosfamide; imatinib imipramine; indinavir; irinotecan; isavuconazonium sulfate; isocarboxazid; itraconazole; ivabradine; ivacaftor; ixabepilone; ixazomib; ketoconazole; lamotrigine; lapatinib; ledipasvir; levonorgestrel; levonorgestrel; linagliptin; linezolid; lopinavir/ritonavir; lurasidone; macitentan; maraviroc; medroxyprogesterone; mestranol; methotrexate; midazolam; mifepristone; naloxegol; naratriptan; nefazodone; nelfinavir; netupitant; nevirapine; nilotinib; nintedanib; norelgestromin; norethindrone; norgestimat; norgestrel; nortriptyline; olaparib; omeprazole; ondansetron; osimertinib; oxycodone; paclitaxel; palbociclib; paliperidone; panobinostat; paritaprevir; paroxetine; pazopanib; pegylated interferon α; perampanel; phenelzine; pimavanserin; ponatinib; praziquantel; procarbazine; protriptyline; quinidine; ramelteon; ranolazine; rasagiline; regorafenib; reserpine; rilpivirine; ritonavir; rivaroxaban; rizatriptan; rolapitant; romidepsin; saquinavir; selegiline; selegiline transdermal; sertraline; sildenafil; simeprevir; sofosbuvir; sonidegib; sumatriptan; sunitinib; tadalafil; talinolol; tasimelteon; telithromycin; temsirolimus; tenofovir alafenamide; ticagrelor; tipranavir; tofacitinib; tolvaptan; trabectedin; tranylcypromine; trazodone; triazolam; ulipristal; vandetanib; velpatasvir; vemurafenib; venetoclax; venlafaxine; vilazodone; vinblastine; vincristine; vinorelbine; vorapaxar; voriconazole; warfarin; zolmitriptan.

    Avoid alcohol while taking St. John’s wort.

    Other drugs that should be avoided while taking St. John’s wort include: acetaminophen; afatinib; aminophylline; amlodipine; aripiprazole; aripiprazole lauroxil; brexpiprazole; buprenorphine; carbamazepine; caspofungin; cinacalcet; ethosuximide; felodipine; fentanyl; gefitinib; guanfacine; hydrocodone; isradipine; methadone; nicardipine; nifedipine; nimodipine; nisoldipine; quinidine (antiarrhythmic); repaglinide; sirolimus; tacrolimus; theophylline; tiagabine; verapamil.

    Other drugs and herbs that may cause interactions include: 5-HTP; aldesleukin; alfentanil; apomorphine; armodafinil; artemether/lumefantrine; atorvastatin; betamethasone; bromocriptine; budesonide; butabarbital; butalbital; calendula; capsicum; ciprofloxacin; clorazepate; clozapine; cocaine topical; conivaptan; cortisone; cyclobenzaprine; dantrolene; dapsone; darifenacin; demeclocycline; desvenlafaxine; dexamethasone; docetaxel; doxycycline; drospirenone; duloxetine; eslicarbazepine acetate; estradiol; estrogens, esterified; estropipate; eszopiclone; ethinyl estradiol; etoposide; ezogabine; gemifloxacin; German chamomile; ginseng, glicazide; Siberian; goldenseal; gotu kola; hydrocortisone; hydroxyprogesterone; imatinib; isotretinoin; kava; lemon balm; levofloxacin; levomilnacipran; levonorgestrel; lorcaserin; lovastatin; medroxyprogesterone; melatonin; meperidine; meprobamate; methohexital; methylene blue; methylprednisolone; milnacipran; minocycline; mirtazapine; mitotane; modafinil; montelukast; morphine liposomal; moxifloxacin; norethindrone; norgestimate; ofloxacin; oxcarbazepine; passionflower; pentazocine; pentobarbital; phenobarbital; pimozide; pomalidomide; posaconazole; pramipexole; prednisolone; prednisone; primidone; progesterone; quinine; risperidone; ropinirole; rosuvastatin; rotigotine transdermal; rufinamide; ruxolitinib; secobarbital; simvastatin; solifenacin; sorafenib; sufentanil; sulfadiazine; sulfadoxine; sulfamethoxazole; sulfasalazine; sulfisoxazole; suvorexant; tamoxifen; teniposide; tetrabenazine; tetracycline; thiotepa; tinidazole; tolcapone; topiramate; toremifene; tramadol; tretinoin; triamcinolone; trimipramine; valerian; valproic acid; vortioxetine; yohimbe; zaleplon; ziconotide; zolpidem; zonisamide.

    Speak with your healthcare provider about all medications and drugs you are taking before beginning a new supplement regimen.   
  • 1 Answer
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    A , Pharmacy, answered

    You should not use St. John’s Wort if you are allergic to it, if you are using a serotonin reuptake blocker, or have a history of severe depression. Do not use this product if you are taking blood thinners, amphetamines, an antidepressant, narcotic analgesics, bromocriptine, pramipexole, or ropinirole. If you are pregnant or nursing, do not use St. John’s Wort unless you consult your health care professional, since it is unknown if it affects the unborn or babies. Do not give this product to a child without first consulting your child’s doctor. Before taking this product, consult with your health care professional if you have any health issues, allergies (particularly to plants), or are taking other medications or supplements because it may be not advisable in some circumstances.

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    A , Pharmacy, answered
    If you have bipolar disorder, do not take St. John's wort without talking to your doctor. It may induce mania (excessive physical activity and impulsive behavior), and like other antidepressants, it may also accelerate your usual cycling between depression and mania. There have been cases in which mania developed after two to eight weeks of treatment with St. John's wort. The mania was relieved when the dose of St. John's wort was decreased and the dose of a mood stabilizer (such as lithium) was increased.
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