St. John's wort
Hypericum perforatum
also known as Hypericum, Tipton's weed, Klamath weed
A yellow-flowered herb with strong evidence for mild to moderate depression, but a long list of serious drug interactions makes it the most caution-requiring herb in common use.
- Strong evidence for mild to moderate depression
- Comparable to standard antidepressants in some trials
- Modulates serotonin, dopamine, and norepinephrine
- Provides antioxidant flavonoids
- Approved in Germany for mild depression
- Used since ancient Greek medicine
Active in Hypericin, Hyperforin, Flavonoids, Tannins.
Major drug interaction warning — induces CYP3A4 enzyme
Reduces effectiveness of birth control pills
Reduces effectiveness of HIV medications, organ transplant drugs, blood thinners, and many others
Risk of serotonin syndrome with SSRIs/SNRIs
Causes photosensitivity — avoid sun exposure
Avoid in pregnancy and nursing
Discontinue 2 weeks before surgery
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