Gradually lower the dose before stopping. The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. John's wort is often used to treat depression. If your depression is causing problems with your daily life, or you are having thoughts of suicide or of harming yourself or others, you need to see a doctor immediately.
John's wort should not be used to treat severe depression. You should see a doctor to make sure you have the right diagnosis before taking St. John's wort. Your doctor can help you determine the right dose and make sure you are not taking medications that might interact with St. Side effects from St.
John's wort are generally mild and include stomach upset, hives or other skin rashes, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. John's wort can also make the skin overly sensitive to sunlight, called photodermatitis. If you have light skin and are taking St. John's wort, wear long sleeves and a hat when in the sun, and use a sunscreen with at least SPF 15 or higher.
Avoid sunlamps, tanning booths, and tanning beds. Other potential concerns about St. John's wort are that it may interfere with getting pregnant or make infertility worse; that it may make symptoms of ADD and ADHD worse, especially among people taking methylphenidate; that it may increase the risk of psychosis in people with schizophrenia; and that it may contribute to dementia in people with Alzheimer disease.
More research is needed. Since St. John's wort can interact with medications used during surgery, you should stop taking it at least 5 days or more before surgery. Make sure your doctor and surgeon know you are taking St.
John's wort if you have bipolar disorder. For people with major depression, there's some concern that taking St. John's wort may increase the risk for mania.
Women who are pregnant, trying to become pregnant, or breastfeeding should not take St. John's wort interacts with a large number of medications. In most cases, St. John's wort makes the medication less effective. In other cases, St. John's wort may make the effects of a medication stronger. If you are being treated with any medications, you should not use St.
John's wort without first talking to your doctor. John's wort may interact with many different medications, including but not limited to the following:. John's wort may interact with medications used to treat depression or other mood disorders, including tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors MAOIs.
Taking St. John's wort with these medications tends to increase side effects, and could lead to a dangerous condition called serotonin syndrome. John's wort with other antidepressants, including:. John's wort at the same time as dextromethorphan, a cough suppressant found in many over-the-counter cough and cold medicines, can increase the risk of side effects, including serotonin syndrome.
John's wort may lower levels of the medication and make it less effective. John's wort if you take digoxin. John's wort can reduce the effectiveness of these medications, which are taken after organ transplant, or to control autoimmune diseases. There have been many reports of cyclosporin blood levels dropping in those with a heart or kidney transplant, even leading to rejection of the transplanted organ.
John's wort appears to interact with at least two kinds of medications used to treat HIV and AIDS: protease inhibitors and non-nucleoside reverse transcriptase inhibitors. The Food and Drug Administration recommends that St.
There have been reports of breakthrough bleeding in women on birth control pills who were also taking St. It is possible that the herb might make birth control pills less effective, leading to unplanned pregnancies. This medication makes your skin more sensitive to sunlight. John's wort also increases skin sensitivity to light. Together, they may have a dangerous impact on skin sensitivity to the sun.
Based on animal studies, St. John's wort may interfere with reserpine's ability to treat high blood pressure. John's wort can lower levels of this medication in the blood. Theophylline is used to open the airways in people with asthma, emphysema, or chronic bronchitis. John's wort can increase the risk of side effects, including serotonin syndrome, when taken with these medications:.
Because St. John's wort is broken down by certain liver enzymes, it may interact with other drugs that are broken down by the same enzymes. Those drugs may include:. Herbal medicines and perioperative care. A systematic review of St. John's wort for major depressive disorder. Syst Rev. Beaubrun G, Gray GE. A review of herbal medicines for psychiatric disorders. Psychiatr Serv. The growing knowledge of St.
John's wort Hypericum perforatum L drug interactions and their clinical significance. Curr Ther Res. Drug interaction with St. John's wort with cyclosporin. Profound drop of cyclosporin A whole blood trough levels caused by St. John's wort Hypericum perforatum [letter]. Comparison of an extract of hypericum LI and sertraline in the treatment of depression: a double-blind, randomized pilot study.
Clin Ther. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment -- results of a large-scale, controlled, observational study.
Potential use of medicinal plants in the treatment of alcoholism. Metabolic drug interactions between antidepressants and anticancer drugs: focus on selective serotonin reuptake inhibitors and hypericum extract. Curr Drug Metab. Carpenter DJ. John's wort and S-adenosyl methionine as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit?
Altern Med Rev. Black cohosh and St. Whether or not you use the term is up to you. Health Conditions Discover Plan Connect. Nutrition Evidence Based How St. John's Wort Fights Depression. What Is St. Summary: St. How Does It Work? It May Be as Effective as Antidepressants. There is strong evidence to support the use of St. In , an in-depth review of 35 studies examined these effects.
Summary: Studies show that St. Other Potential Benefits. Wound healing: When applied to the skin, it has been found to effectively treat pressure sores, wounds, bruises, burns and hemorrhoids 10 , Symptoms of menopause: One small study found a significant reduction in menopause-related symptoms after taking liquid St. There is fairly weak evidence supporting the use of St. Cancer: Test-tube studies have shown that the hypericin in St. However, there is currently no evidence to support these claims.
Summary: There is some evidence that St. It May Not Be for Everyone. Side Effects Most people who take St. Pregnancy and Breastfeeding A small number of observational studies have looked at the risk of taking St. However, midwives often recommend St.
Withdrawal The evidence on St. Summary: Some side effects have been reported with the use of St. This can lead to serotonin syndrome, a rare condition in which levels of serotonin become too high and, in extreme cases, can be fatal 28 , Birth control pills: Unexpected bleeding can occur mid-cycle with the combined use of birth control pills and St.
It may also decrease the effectiveness of birth control 30 , Warfarin: Warfarin is a blood-thinning medication commonly used to prevent heart attacks, strokes or blood clots. Cancer medication: St. Xanax: It has been shown to reduce the effectiveness of Xanax, an anxiety medication Depression major depressive disorder or clinical depression is a common but serious mood disorder.
It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. In , almost 7 percent of U. Symptoms of depression vary but can include. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
Email: info nccih. To provide resources that help answer health questions, MedlinePlus a service of the National Library of Medicine brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.
Email: nimhinfo nih. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.
Davidson, M. Craig Hopp, Ph. This publication is not copyrighted and is in the public domain. Duplication is encouraged. NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider s. We encourage you to discuss any decisions about treatment or care with your health care provider. Depression NIMH. Depression and Complementary Health Approaches. Home Health Information St. John's Wort and Depression: In Depth.
How much do we know about St. We know a fair amount about the short-term effects of St. What do we know about the effectiveness of St.
Do not use it to replace conventional care or to postpone seeing your health care provider. What do we know about the safety of St. Combining St.
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