St John’s Wort…A Holy Antidepressant?

St John’s Wort, (or for the sake of my fingers SJW) is a herb which has seen medicinal use for at least centuries. Early uses revolved around pain and wound healing, and it has not been until recently that SJW has achieved almost a cult following for its antidepressant qualities. But what is SJW good for, what are its risks, and how should it be used? We will explore that here.

What is SJW?

St. John’s wort (Hypericum perforatum), a plant that grows in the wild, has been used for centuries for mental health conditions. Many studies have been conducted to evaluate the effectiveness of St. John’s wort. Some studies have suggested benefit, but other studies have not.

Does it Work?

St John’s wort is a proven anti-depressant. When I say that people often think that means it will work for everyone, every time. However this is not how anti-depressant medications work. Because our ability to measure the chemical imbalances in our brains is essentially negligible, psychiatrists basically guess at what medication would be a good one to start with. A similar process is done with dosing, and often it takes months to find a dose that is effective for an individual. And that may be the best case when you don’t have to switch medication after a couple months of taking it.

While that may seem to many to be a condemnation of our current mental health system, it isn’t meant to be that at all. Instead we should all understand the limitations of the medical system we have, and be prepared for what we will get.

The Science

When researchers at the Rand Corporation, a nonprofit global policy think tank, looked at 35 studies using the herb for mild-to-moderate depression they found that, for their participants, SJW was just as effective as taking an antidepressant. Their review, published in the journal Systematic Reviews in 2016, also revealed that in studies pitting SJW against a placebo, SJW came out ahead. Even better, side effects were significantly lower for people on SJW than a medication. They had fewer stomach/intestinal or neurological problems, and lower rates of sexual concerns.

The scientific evidence is not entirely positive, as should be expected (for more info check out my post about how to read science). There were a handful of studies which were inconclusive, and another handful which showed SJW was less effective than a placebo.

While the researchers didn’t conclude why SJW wasn’t effective in those individuals, I suspect it had something to do with way SJW interacted with their brain chemistry. So if you take SJW, and it doesn’t work for you, don’t despair, that is an important data point, and one that you should share with your psychiatrist to help find you the medication that will work best.

How do you Use SJW?

St. John’s wort is most often taken in liquid or capsule form. The dried herb may also be used as a tea.

The most common dose used in studies has been 300 mg, three times a day as a standardized extract. Preparations in the U.S. have varied amounts of active ingredient in them. So be careful to note how much you’re getting in your tablets.

What are the side Effects

The most common side effects of SJW are :

  • Allergic reactions
  • Fatigue and restlessness with long-term use
  • Increased blood pressure
  • Increased sensitivity to the sun — especially if you are fair-skinned and taking large doses
  • Upset stomach

SJW is not recommended for pregnant women, children, the elderly. Research from the National Institute of Health has shown that St. John’s wort may reduce the effectiveness of several drugs, including birth control pills, drugs used to prevent organ transplant rejections, and some heart disease medications.

Combining St. John’s wort with certain antidepressants can lead to a potentially life-threatening increase of serotonin, a brain chemical targeted by antidepressants. Symptoms occur within minutes , and may include agitation, diarrhea, fast heartbeat, high blood pressure, hallucinations, increased body temperature, and more. If you experience these symptoms shortly after taking SJW, immediate call 911.

Conclusion

The bottom line for St John’s wort is that it works…but not for everyone

It is largely safe…but has some risks

But at the end of the day…don’t try to treat depression on your own. Depression can become severe if you don’t get effective, professional help. For some people, depression can increase the risk of suicide. Talk to your health care provider if you or someone you know may be depressed.

If you want to learn more about depression, check out my post here. Or if you just wandered in here, check out what Fully Human is all about or check out some of our anti-inflammation posts. Subscribe below to keep updated on how to bring your full self to life.

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