St. John's wort for depression and anxiety

 St. John's wort is a wild plant with five-petaled yellow blooms in clusters. It gets its name from the fact that it blooms around St. John the Baptist's birthday, June 24. For thousands of years, people have utilised the blooms and leaves of this plant to treat many ailments.

St. John's wort benefits

St. John's wort, which functions similarly to an SSRI, also inhibits serotonin reabsorption in the central nervous system, boosting the availability of the brain chemicals serotonin, dopamine, and norepinephrine. These neurotransmitters aid in mood enhancement. Because St. John's wort includes a range of polyphenols, including rutin, it may have more antioxidant and anti-inflammatory properties than pharmaceuticals.

St. John's wort for depression and anxiety

A 2015 meta-analysis research [1], which included 66 prior studies and a total of 15,161 patients, compared the impact of antidepressants with other drugs, including St. John's wort. The researchers determined that St. John's wort showed some impact compared to placebo, but the study data was insufficient to advocate therapeutic usage.

The 2010 American Psychiatric Association medical report [2] said that, while there is no consistent scientific evidence on St. John's wort, more study will be published in the future. St. John's wort may cause mild to moderate illness in certain persons as a treatment options for depression.

In a randomized controlled clinical trial in 2011 [3], whether it was St. John's Wort or the SSRI drug Citalopram (Citalopram), there was no significant difference compared to placebo after 12 weeks of use.

In 2012, a research on major depressive illness [4] discovered that whether it was St. John's wort, the SSRI medicine Sertraline (Sertraline), or placebo, the therapeutic impact was equivalent after 26 weeks of therapy, that is, whether it was St. John's wort or SSRIs have been demonstrated to be more effective than a placebo in clinical trials.

The country that clinically uses St. John's Wort as a treatment for depression, Germany may be regarded as the earliest and most used country. St. John's Wort was prescribed as high as 66 million doses a year! [5] St. John's wort has been shown to work as well as SSRI drugs, but like drugs, it's actually not that different from a placebo. The above studies are all short-term clinical studies, and related meta-analysis, long-term use of St. John's wort, there are two possibilities, one is that, like SSRI drugs, it will cause drug resistance and require higher and higher doses to achieve the effect, It is not sure whether it is safe in the long term; secondly, St. John's wort contains polyphenols such as rutin, which has antioxidant and anti-inflammatory effects that SSRI drugs do not have. Can long-term use be more effective by reducing inflammation? This needs more research to prove. St. John's wort is recommended for short-term use and is a good alternative when not taking prescription drugs.

How long does it take for St. John's wort to work?

You may not feel the full advantages of St. John's wort for two to six weeks, depending on the type you take. Again, there is no evidence that this supplement works, so you may not see any results at all. It is advisable to consult with your healthcare practitioner to determine what is best for you.

Do I need a prescription for St. John's wort?

The Food and Drug Administration (FDA) considers Trusted Source St. John's wort to be a nutritional supplement and does not authorise it for use as a medicine in the United States.

As a result, St. John's wort is available without a prescription in the United States and many other nations. However, in certain countries, like as Ireland, a prescription is required to obtain it.

Safety and Side Effects

St. John's wort is usually safe when taken by mouth in appropriate doses for no longer than 12 weeks. but may cause:

     • Restlessness and anxiety

     • Dizziness

     • Diarrhea, constipation and upset stomach

     • dry mouth

Other side effects may include:

     • Fatigue and insomnia

     • Headache

     • Increased sensitivity to sunlight (photosensitivity)

There isn't enough information about the safety of topical St. John's wort.

Do not use St. John's wort during pregnancy and breastfeeding.

Is there anything I should be concerned about when taking St John's wort?

Many different drugs can be affected by St. John's wort. Many common medicines can create significant and perhaps hazardous interactions with it. St. John's wort may potentially reduce the efficacy of other drugs. These combinations may render your medications ineffective.

Combining St. John's wort with SSRIs may result in a potentially fatal spike in serotonin. This can result in a disease known as serotonin syndrome. The consequences of serotonin syndrome might take minutes or hours to manifest. Among these signs are:

 

     • Rapid heartbeat.

     • High blood pressure.

     • Increased body temperature.

     • Hallucinations.

Ask your doctor before combining St. John's wort with any other medications, especially prescription medications.

REF：

[1]Linde, K., Kriston, L., Rücker, G., Jamil, S., Schumann, I., Meissner, K., Sigterman, K., & Schneider, A. (2015). Efficacy and acceptability of pharmacological treatments for depressive disorders in primary care: systematic review and network meta-analysis. Annals of family medicine, 13(1), 69–79.https://doi.org/10.1370/afm.168

[2]Freeman, M. P., Fava, M., Lake, J., Trivedi, M. H., Wisner, K. L., & Mischoulon, D. (2010). Complementary and alternative medicine in major depressive disorder: the American Psychiatric Association Task Force report. The Journal of clinical psychiatry, 71(6), 669–681.https://doi.org/10.4088/JCP.10c

[3]Rapaport, M. H., Nierenberg, A. A., Howland, R., Dording, C., Schettler, P. J., & Mischoulon, D. (2011). The treatment of minor depression with St. John's Wort or citalopram: failure to show benefit over placebo. Journal of psychiatric research, 45(7), 931–941.https://doi.org/10.1016/j.jpsyc

[4]Sarris, J., Fava, M., Schweitzer, I., & Mischoulon, D. (2012). St John's wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT. Pharmacopsychiatry, 45(7), 275–278.https://doi.org/10.1055/s-0032-

[5]Peter Smet (1996),Letter, St John’s Wort as an antidepressant,BMJ Volume 313 3 Aug 1996 https://doi.org/10.1136/bmj.313.7052.241