Treatment Options

St. John's Wort

Possible Harm/No Value

St. John’s wort is a bushy, low-growing plant covered with yellow flowers that grows in Europe, California and Oregon. It is also known as: Hypericum perforatum, hypericum, Klamath weed and goat weed. St. John’s wort is an herbal product sold as a dietary supplement. It is referred to as a complementary and alternative treatment. 

St. John's wort has been used for nerve pain, as a sedative, as treatment for malaria and as a balm for wounds, burns and insect bites. Today, it is used by some for depression, anxiety and/or sleep disorders.

There is some scientific evidence from European studies that St. John's wort is useful for treating mild to moderate depression. A more recent study conducted in the United States by the National Institutes of Health indicates that St. John's wort is not effective in treating major depression of moderate severity. More research is needed to help us know whether St. John's wort has value in treating other forms of depression.

It is known that St. John's wort interacts with some drugs, and these interactions can be dangerous. It affects the way the body processes or breaks down the drugs. Based on reports in the medical literature, St. John’s wort appears to be an inducer of an important metabolic pathway, cytochrome P450. There is not a standard dosage and length of treatment recommended for St. John’s wort.

Things to Consider

  • The U.S. Food and Drug Administration issued a public health advisory February 10, 2000 regarding the use of St. John’s wort.  The advisory recommended that health care providers alert their patients about potential drug interactions when taking St. John’s wort.
  • At this time, it is not known what role St. John's wort should play in the management of depression. If depression is not adequately treated, it can become severe and, in some cases, may be associated with suicide. Consult a health care practitioner if you or someone you care about may be experiencing depression.
  • Seek the advice of your physician when considering any kind of complementary and alternative treatment choice.

Results

Possible Harm/No Value

Will I live longer if I receive the hepatitis B vaccine?

There is no scientific evidence available to indicate that taking St. John’s wort will help you live longer.

Will taking St. John’s wort improve my quality of life?

There is no scientific evidence available to indicate that taking St. John’s wort will improve your quality of life.

Safety

Possible Harm/No Value

How safe is this for me?

The U.S. Food and Drug Administration issued a public health advisory February 10, 2000. The advisory states that St. John’s wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as AIDS, heart disease, depression, seizures, certain cancers and rejection of transplants. The advisory recommended that health care providers should alert their patients about these potential drug interactions. Also, St. John’s wort is not recommended for use by pregnant women.

A study conducted by the National Institutes of Health indicates that St. John's wort is not effective in treating major depression of moderate severity. At this time, it is not known what role St. John's wort should play in the management of depression.

Reported complications:

  • Anxiety
  • Dry mouth
  • Dizziness
  • Fatigue
  • Gastrointestinal symptoms
  • Headache
  • Increased sensitivity to sunlight
  • Sexual dysfunction

Drug Interactions – notify your physician/health care provider of any complementary and alternative treatment you use before undergoing any type procedure, before you begin taking new medication and when you are currently taking medication.

Some drugs that can be affected by St. John’s wort include, but may not be limited to, the following:

  • Anesthesia – drugs used for sedation during procedures
  • Antidepressants – may also increase side effects such as anxiety, confusion, headache and nausea
  • Birth control pills
  • Cyclosporine – prevents the body from rejecting transplanted organs
  • • Chemotherapy and other drugs used to treat cancer
  • Digoxin – strengthens heart muscle contractions
  • Indinavir and possibly other drugs used to control HIV infection
  • Warfarin and related anticoagulants

Comparison

Possible Harm/No Value

Much more information is needed before a comparison can be made, including studies that compare St. John's wort with other treatments.

Cost

Possible Harm/No Value

The cost for St. John’s wort is dependant on manufacturer, dose and method of administration.

Seek the advice of your physician when considering any kind of complementary and alternative treatment choice.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

Medline Plus. U. S. National Library of Medicine. National Institutes of Health. (2012, December). St. John's wort (hypericum perforatum L.).  Retrieved August 12, 2013 from  

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-stjohnswort.html.

National Center for Complementary and Alternative Medicine. National Institutes of Health. (2012, April).  St. John's wort. Retrieved August 12, 2013 from http://nccam.nih.gov/health/stjohnswort/ataglance.htm.

National Center for Complementary and Alternative Medicine. National Institutes of Health. (2008, June). St. John's wort shows no impact on the symptoms of ADHD. Retrieved August 12, 2013

from http://nccam.nih.gov/research/results/spotlight/061008.htm.

National Center for Complementary and Alternative Medicine. National Institutes of Health. (2012, September). St. John's wort and depression. Retrieved August 12, 2013 from http://nccam.nih.gov/health/stjohnswort/sjw-and-depression.htm.   

National Institute of Allergy and Infectious Diseases. National Institutes of Health. (2000, February). NIH Clinical Center study demonstrates dangerous interaction between St. John's wort and an HIV protease inhibitor.  Retrieved August 12, 2013 from http://nccam.nih.gov/news/19972000/021000.htm.

Next Review Date

8/22/2014

This document has been classified as public information.

Table of Findings

results:  possible harm / no value

safety:  possible harm / no value

comparison:  possible harm / no value

cost: possible harm / no value


total: possible harm / no value

legend

scale

Page modified:November 12, 2012