St. John's wort (Hypericum perforatum L.)

background

Extracts of Hypericum perforatum L. (St. John's wort) have been recommended traditionally for a wide range of medical conditions. The most common modern-day use of St. John's wort is for depression. Studies have shown St. John's wort may be equally effective as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitor (SSRI) antidepressants for mild to moderate depression.
Overall, the evidence suggests St. John's wort may be effective for in mild-to-moderate depression. The evidence for severe depression remains unclear.
St. John's wort may cause serious interactions with prescription drugs, herbs, or supplements. Therefore, people using any medications should consult their healthcare providers, including a pharmacist, prior to starting therapy.

Related Terms

Adhyperforin, Amber touch-and-heal, amino acids, arnica of the nerves, balm-of-warrior's wound, balsana, bassant, Blutkraut, bossant, Calmigen®, corancillo, dendlu, devil's scorge, Eisenblut, flor de São João, flavonoids, fuga daemonum, goatweed hartheu, heofarigo on, herba de millepertius, herba hyperici, Herrgottsblut, Hexenkraut, hierba de San Juan (Spanish), hipericão (Portuguese), hipérico (Spanish), hipericon, HP, hyperforin, hypericin, Hypericum extract ZE 117, Hypericum perforatum L, isorhamnetin, Jarsin, Johanniskraut, klammath weed, Liebeskraut, LI 160, LoHyp-57, lord God's wonder plant, melatonin, millepertius pelicao, naphthodianthrones, oligomeric procyanidines, perforate, phloroglucinols, pinillo de oro, PM235, pseudohypericin, quercetin, rosin rose, rutin, Sedariston®, SJW, SJW extract LI 160, St. John's wort WS 5572, STW 3-VI, tenturotou, Teufelsflucht, touch and heal, Walpurgiskraut (German), witcher's herb, WS® 5570, WS 5572, WS 5573, xanthones, ZE117.

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
Depression (mild-to-moderate) (Grade: A)
Human research suggests that St. John's wort is more effective than placebo and equally as effective as TCAs and SSRIs in the short-term for mild-to-moderate depression. Although St. John's wort has been shown to have fewer side effects than SSRIs, it should be used with caution and guidance of a medical professional.
Somatoform disorders (Grade: B)
Somatoform disorders are mental symptoms such as pain and fear that lack a physical source or reason for their existence. Early evidence shows that St. John's wort may help with somatoform disorders. Further research is needed to confirm these results.
Anxiety disorder (Grade: C)
Early research has shown promising effects of St. John's wort for anxiety disorders. High quality evidence is lacking. Further research is needed to make conclusions.
Atopic dermatitis (eczema) (Grade: C)
Early research of hypericum-cream had shown positive results for atopic dermatitis, or itchy and scaly rashes. Further studies are needed before a firm recommendation can be made.
ADHD (children) (Grade: C)
It is unclear whether St. John's wort is an effective treatment in children with ADHD. More study is needed to confirm these findings.
Bone diseases (Grade: C)
A combination product including St. John's wort improved healing for diabetic foot ulcers and bone disease. Further study of St. John's wort alone is warranted before a conclusion may be drawn.
Brain tumors (Grade: C)
Early human study showed effectiveness of St. John's wort in decreasing brain tumor size. Further study is warranted before a conclusion may be drawn.
Depression (children) (Grade: C)
Early research suggested effectiveness of St. John's wort for depression in children. Higher quality research is needed before a conclusion may be drawn.
Depressive disorder (severe) (Grade: C)
Although human research is promising, the effectiveness of St. John's wort for severe depression is unclear. Additional well-designed research needed before a conclusion may be made.
Herpes (Grade: C)
Early research shows that a combination product containing St. John's wort improved symptoms of herpes. Further research is warranted before a conclusion may be drawn.
Menopausal symptoms (Grade: C)
Sufficient evidence is lacking to recommend St. John's wort for menopausal symptoms such as depressed mood and hot flashes. More research is needed.
Nerve pain (Grade: C)
Early study shows that St. John's wort may help nerve pain. Further research is needed to confirm these results.
Obsessive-compulsive disorder (OCD) (Grade: C)
Evidence for the use of St. John's wort in obsessive-compulsive disorder (OCD) is conflicting. Further research is needed before a conclusion may be drawn.
Pain (burning mouth syndrome) (Grade: C)
It is unclear whether St. John's wort is an effective treatment for pain associated with burning mouth syndrome. More research is needed.
Pain relief (after surgery) (Grade: C)
It is unclear whether St. John's wort is an effective treatment for pain after surgery. More research is needed.
Premenstrual syndrome (PMS) (Grade: C)
The effectiveness of St. John's wort for PMS symptoms such as anxiety, depression, and cravings is unclear. Further studies are needed before a conclusion can be made.
Seasonal affective disorder (SAD) (Grade: C)
Although early research is promising, there is insufficient evidence supporting the use St. John's wort for depression due to SAD. Further studies are needed before a conclusion can be made.
Skin disorders (Grade: C)
Limited research shows the effectiveness of St. John's wort in treating various skin disorders. Further study is warranted before a conclusion may be drawn.
Smoking cessation (Grade: C)
Early research shows the effectiveness of St. John's wort for smoking cessation or in helping to quit smoking. Further research is warranted before conclusions may be made.
Social phobia (Grade: C)
The effectiveness of St. John's wort for social phobia is unclear. More study is needed.
Weight loss (Grade: C)
Early research shows that a combination product containing St. John's wort was effective for weight loss. Further research of St. John's wort alone is needed before a conclusion may be drawn.
Wound healing (Grade: C)
Limited research shows that St. John's wort improved wound healing and decreased the formation of scars. Further study is warranted before a firm conclusion may be drawn.
HIV (Grade: D)
Non-human research shows anti-viral effects of St. John's wort in AIDS/HIV, but these effects in human research are lacking. There have been multiple reports of significant adverse effects and interactions with drugs used for HIV/AIDS, such as protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). Therefore, patients treated for HIV/AIDS should avoid St. John's wort.
Irritable bowel syndrome (IBS) (Grade: D)
Human research shows a lack of effectiveness and possible harm of St. John's wort in IBS. Overall, there is a lack of quality research. Further research is required.