St. John's Wort - 90 Veggie Capsules

Background: St. John's wort is a flowering plant native to Europe, but also naturalized in North and South America, Australia, New Zealand, and Eastern Asia

Ingredients: Fresh St. John's Wort, Grain Alcohol, Deionized Water

Amount Per Serving: 450 mg per 1 veggie capsule

Serving Size: 1 capsule: 1-3 times daily

Properties: Anti-Depressent, Sedative, Vulnerary (heals tissue)

Indications:

Clinical guidelines from the American College of Physicians-American Society of Internal Medicine suggest that St. John's wort can be considered an option along with conventional antidepressants for short-term treatment of mild depression (1). However, since St. John's wort has not been shown to be more effective and since St. John's wort causes many drug interactions, it might not be an appropriate choice for many patients, particularly those who take other conventional drugs.

Adverse Effects:

Orally, St. John's wort is usually well tolerated (2). Side effects can include insomnia, vivid dreams, restlessness, anxiety, agitation, irritability, gastrointestinal (GI) discomfort, diarrhea, fatigue, dry mouth, dizziness, and headache. Insomnia can often be alleviated by decreasing the dose or taking St. John's wort in the morning

Caution: Not recommended if nursing or pregnatn. St. John's wort has been associated with potentially serious interactions with certain drugs. May potentiate MAO-inhibitors. Check with your doctor to see if St. John's Wort is appropriate if you are on medications or are severely depressed.

Interactions with Drugs:

Interaction Rating = Be cautious with these combinations.
5-HT1 AGONISTS ("Triptans")
AMINOLEVULINIC ACID
AMITRIPTYLINE (Elavil)
ANTIDEPRESSANT DRUGS
BUPROPION (Wellbutrin)
CLOPIDOGREL (Plavix)
CYCLOSPORINE (Neoral, Sandimmune)
CYTOCHROME P450 SUBSTRATES
DEXTROMETHORPHAN (Robitussin DM, others)
FEXOFENADINE (Allegra)
GLICLAZIDE (Diamicron, Dacadis, Nazdol, Zicron)3
MEPERIDINE (Demerol)
METHADONE (Dolophine)
MONOAMINE OXIDASE INHIBITORS (MAOIs)
NEFAZODONE (Serzone)
NORTRIPTYLINE (Pamelor, Aventyl)
PAROXETINE (Paxil)
PENTAZOCINE (Talwin)
PHOTOSENSITIZING DRUGS
PROCAINAMIDE (Pronestyl, Procan, Procanbid)
RESERPINE (Raudixin, Serpalan, Serpasil)
SERTRALINE (Zoloft)
SIMVASTATIN (Zocor)
TRAMADOL (Ultram)
VORICONAZOLE (Vfend)
ZOLPIDEM (Ambien)

Interaction Rating = Major Do not take this combination.
ALPRAZOLAM (Xanax)
CONTRACEPTIVE DRUGS
DIGOXIN (Lanoxin)
DOCETAXEL (Docefrez, Taxotere)
FENFLURAMINE (Pondimin)
IMATINIB (Gleevec)
IRINOTECAN (Camptosar)
KETAMINE (Ketalar)
MEPHENYTOIN (Mesantoin)
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)
OMEPRAZOLE (Prilosec, Zegerid)
P-GLYCOPROTEIN SUBSTRATES
PHENOBARBITAL (Luminal)
PHENPROCOUMON (Marcoumar, Marcumar, Falithrom)
PHENYTOIN (Dilantin)
PROTEASE INHIBITORS (PIs)
TACROLIMUS (Prograf, Protopic)
WARFARIN (Coumadin)

References:

1. Snow V, Lascher S, Mottur-Pilson C. Pharmacologic treatment of acute major depression and dysthymia. Ann Intern Med 2000;132:738-42.
2. Melzer, J., Brignoli, R., Keck, M. E., and Saller, R. A hypericum extract in the treatment of depressive symptoms in outpatients: an open study. Forsch.Komplementmed. 2010;17(1):7-14.

Blumeenthal M, The Clinical Guide to Herbs. Thieme, New York: 2003: p. 321-334.