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Just what is St John’s Wort?

St John’s Wort (botanical name hypericum perforatum) is native to Europe, North Africa and some areas of Asia. It is now also grown in Australia and North America. There are dozens of different species of hypericum known to botanists and scientists but the hypericum perforatum is used most commonly today in herbal medicine.

It has been used in medicine for thousands of years for a variety of ailments including the treatment of bruises, dysentery, jaundice, diarrhoea and a wide range of other complaints.

In recent years however, it has become increasingly popular as a herbal alternative to antidepressant drugs in the treatment of mild to moderate clinical depression. Research has so far not found St John’s Wort to be particularly helpful in severe depression. Furthermore, those suffering from severe depression must seek medical advice rather than trying to self-medicate.

One main reason for the increased popularity of St John’s Wort is the number of side-effects which prescription antidepressants have. Just a few include insomnia, dizziness, loss of concentration and problems with memory loss. By comparison, St John’s Wort appears to have few side effects. Furthermore, unlike many antidepressants St John’s Wort does not appear to cause sexual dysfuntion and loss of libido. For many patients that is reason enough to try it!

I have seen St John’s Wort have an almost miraculous effect when prescription drugs have failed. But St John’s Wort is not really a wonder drug. It will work for some and not for others. I have heard it called ‘nature’s Prozac’ - that’s not true. Just because you can go into a store and buy St John’s Wort without a prescription from a doctor does not mean that it is necessarily good for you. You don’t need a prescription to buy whisky or cigarettes but you wouldn’t claim that they’re particularly good for your health!

Anybody contemplating taking St John’s Wort should first contact a medical professional. There are potential side-effects to taking St John’s Wort and research into the long term effects of taking it is still ongoing. In Europe, products using St John’s Wort are regulated by European law. However, the regulations are not as strict as some would like given that the full effects of St John’s Wort are still unknown. As far as I am aware the US FDA has not approved St John’s Wort for medical use. This means US consumers have to be particularly careful about the potency and purity of any products containing St John’s Wort.

If you are taking any other medication for any other condition, including oral contraception, check with a doctor first before taking St John’s Wort. You need to be sure that St John’s Wort will a) not react with your medication to produce a harmful effect or b) inhibit the effectiveness of your prescription. Like any medication, if you are pregnant, nursing or trying to conceive, check first with your doctor before taking St John’s Wort.

Those who have suffered for any length of time from depression know how easy it is to become a medication bore. Many people take a bewildering range of antidepressants with varying doses before they find the one that seems to work for them: SSRIs (Prozac or Zoloft); MAOIs; newer antidepressants like Effexor; tricyclic antidepressants (amitriptyline, imipramine, and maprotiline); non-tricyclics etc. etc. These work in different ways, on different substances and systems in the brain and have a range of side-effects ranging from the inconvenient to the potentially lethal if not monitored closely.

So what does St John’s Wort do?

Trials carried out around the world suggest that St John’s Wort has anti-anxiety and antidepressant effects. Some antidepressants are designed to stimulate. St John’s Wort is not a stimulant, rather a mild sedative. This is why is has been found to be useful in patients suffering mild depression with high levels of anxiety. As a result some research has suggested that it may be more useful for those currently taking drugs like venlafaxine (Effexor) and buproion (Wellbutrin) rather than Prozac. However as every patient is different, this has not been definitively proved and the medical community has made it clear that they require a lot more research to be done before they are willing to say that St John’s Wort works as well as prescribed antidepressants

The plant itself contains several chemicals which may have an antidepressant function. Hyperforin is the one most commonly attributed with giving St John’s Wort its ability to act as an antidepressant. Hyperforin inhibits the reuptake of serotonin, norepinephrine and dopamine in the brain allowing them to stay at higher levels in the brain rather than being reabsorbed.

Are there any side effects?

These are thankfully pretty rare. However, if you do develop any side-effect after taking St John’s Wort, stop taking it immediately and if in any doubt seek medical help. The side effect may be due to the dosage or the particular St John’s Wort product you have taken.

Some people develop a rash. This could be an allergy to the herb itself. However as most people take St John’s Wort in tablet or capsule form rather than as an infusion made from the actual herb it could be a reaction to something else involved in its manufacture. Like any new substance introduced to the body for the first time, you could also suffer an upset stomach as a result of taking St John’s Wort.

Another potential side-effect is increased photo sensitivity. This means you become more sensitive to sunlight and have to be even more aware of the need for sunscreens than most people. In this day and age as the incidence of skin cancers grows around the world we are all being advised to avoid tanning, wear good sun protection daily (SPF 15 at least) and avoid burning our skin. If you are fair-skinned hopefully you will follow such advice anyway. However, if you take St John’s Wort, this is something to pay extra attention to, whatever your skin colour.

A few people have found that rather than relaxing them, using St John’s Wort leaves them feeling exhausted. However, many people feel much more tired and fatigued as a result of using medically-prescribed antidepressants. As St John’s Wort does have a mild sedative effect you should check with a medical professional if this becomes a problem.

So if you’re having a bad day, don’t reach for the St John’s Wort. If you’re just feeling down I’d recommend a walk in the fresh air or a hug from a friend before reaching for this or any other treatment. If however, you have been diagnosed with clinical depression by a trained medical professional and you are keen to avoid, or cut out antidepressant medication, St John’s Wort may offer an alternative with fewer side-effects.