St. John's Wort for Treating Depression

Is St. John's wort, an herbal remedy, effective in treating depression? Millions of people think so; they view St. John's wort as an alternative or natural treatment for depression.

What is a dietary supplement?

According to the FDA, dietary supplements include vitamins, minerals, herbs, and amino acids. They come in the form of pills, liquids, or powders, and are intended to be taken to supplement the diet. Dietary supplements are not regulated the same way as drug products.

What is St. John's wort?

The St. John's wort plant has yellow flowers and is sometimes thought of as a weed in some parts of the United States. It has been used for medical purposes in other parts of the world for thousands of years. Many studies have been conducted to evaluate the effectiveness of St. John's wort. Some studies have suggested benefit, but other studies have not.

While the true benefits of St. John's wort are still being explored, if you do choose to use it, be sure to learn all you can and check with your doctor before taking it. St. John's wort can interact with other medicines or supplements you may be taking and may have side effects.

Is there scientific evidence that supports the use of St. John's wort for depression?

There is some scientific evidence that St. John's wort may be helpful in treating mild depression, and the benefit seems similar to that of antidepressants. However, two large studies, one sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), showed that the herb was no more effective than placebo in treating major depression of moderate severity; ironically, the conventional drugs also studied did not fare any better than placebo, either.

How do I take St. John's wort?

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 should I watch for if I take St. John's wort?

You should be alert for any of the following effects if you are taking St. John's wort:

  • 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
  • Stomach upsets

What precautions should I take with St. John's wort?

Herbal therapies are not recommended for pregnant women, children, the elderly, or those with certain medical conditions or taking certain medicines.

Research from NIH 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. Talk to your doctor about all the medications you are taking.

Always tell your doctor if you are taking St. John's wort or any other herbal product.

What other precautions should I take with herbal remedies?

Here are additional precautions you need to take to increase the safety of using herbal remedies:

  • Discuss any drugs or supplementsyou use, including herbal products, with your doctor.
  • If you experience side effects such as nausea, vomiting, rapid heartbeat, anxiety, insomnia, diarrhea, or skin rashes, stop taking the herbal product and notify your doctor.
  • Beware of commercial claims of what herbal products can do. Look for scientific-based sources of information.

Which brands of herbal products should I use?

Only purchase brands that list the herb's common and scientific name, the name and address of the manufacturer, a batch and lot number, expiration date, dosage guidelines, and potential side effects.

WebMD Medical Reference Reviewed by David Kiefer, MD on March 21, 2016



National Institute of Mental Health: "Depression."

National Center for Complementary and Alternative Medicine: "St. Johns Wort and Depression."

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

FDA: "Overview of Dietary Supplements."

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