Introduction
St. John’s wort is a plant with bright yellow flowers. The flowers have been used to ease symptoms of depression and menopause. St. John’s wort has also been applied as an ointment to help promote healing in skin problems, such as scarring and psoriasis. St. John’s wort can be taken as a pill, powder, or extract. It can also be applied as an oil or made into a tea.
Dosages
300 milligrams 2 to 3 times daily
What Research Shows
Likely Effective
- Depression —likely to reduce symptoms F1-F7
- Menopause —likely to ease symptoms G1, G2
May Be Effective
- Atopic eczema —may help manage symptoms B1
- Cesarean section—may improve pain and scarring when applied as an ointment E1
May Not Be Effective
- Anxiety —may not ease anxiety A1
- Attention deficit hyperactivity disorder —may not ease symptoms C1
- Burning mouth syndrome—may not improve symptoms D1
- Premenstrual Syndrome (PMS) —may not ease symptoms J1
- Smoking cessation —may not aid cessation L1
Unlikely to Be Effective
- Tooth pain —unlikely to relieve pain M1
Not Enough Data to Assess
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Safety Notes
It is likely safe for most adults to take St. John’s wort orally in small doses for a short time, but reactions affecting the skin, stomach, muscles, and nerves are possible. Large doses may not be safe. Not enough studies have been done to say whether it is safe to use on the skin or by mouth for a long period. Women who are pregnant or breastfeeding should not use St. John’s wort. K1-K3
Interactions
Talk to your doctor about any supplements or therapy you would like to use. St. John’s wort interacts with many over the counter and prescription medications and can interfere with treatment or make conditions worse such as:
- People with cancer, diabetes, or HIV should talk to their doctors before taking St. John’s wort. It may interact with their medicines.
- People taking migraine medication should talk to their doctor before taking St. John’s Wort. It may interact with the medicine.
- St. John’s wort may be dangerous when taken with anesthetics. It may cause heart failure or coma.
- People taking heart medication should talk to their doctor before taking St. John’s wort. It may interact with the medicine.
References
REFA Anxiety
REFA1 Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010 Oct 7;9:42.
REFB Atopic Eczema
REFB1 Thandar Y, Gray A, et al. Topical herbal medicines for atopic eczema: a systematic review of randomized controlled trials. Br J Dermatol. 2017 Feb;176(2):330-343.
REFC Attention Deficit Hyperactivity Disorder
REFC1 Sarris J, Kean J, et al. Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence. Complement Ther Med. 2011 Aug;19(4):216-227.
REFD Burning Mouth Syndrome
REFD1 Liu YF, Kim Y, et al. Burning mouth syndrome: a systematic review of treatments. Oral Dis. 2018 Apr;24(3):325-334.
REFE Cesarean Section
REFE1 Samadi S, Khadivzadeh T, et al. The effect of Hypericum perforatum on the wound healing and scar of cesarean. J Altern Complement Med. 2010;16(1):113-117.
REFF Depression
REFF1 Nahas R, Sheikh O. Complementary and alternative medicine for the treatment of major depressive disorder. Can Fam Physician. 2011;57(6):659-663.
REFF2 Sarris J, Panossian A, et al. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol. 2011 Dec;21(12):841-860.
REFF3 Purgato M, Papola D, et al. Paroxetine versus other anti-depressive agents for depression. Cochrane Database Syst Rev. 2014 Apr 3;(4):CD006531.
REFF4 Apaydin EA, Maher AR, et al. A systematic review of St. John’s wort for major depressive disorder. Syst Rev. 2016;5(1):148.
REFF5 Seifritz E, Hatzinger M, et al. Efficacy of Hypericum extract WS (®) 5570 compared with paroxetine in patients with moderate major depressive episodes-a subgroup analysis. Int J Psychiatry Clin Pract. 2016;20(3):126-132.
REFF6 Ng QX, Venkatanarayanan N, et al. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. J Affect Disord. 2017;210:211-221.
REFF7 Asher GN, Gartlehner G, et al. Comparative Benefits and Harms of Complementary and Alternative Medicine Therapies for Initial Treatment of Major Depressive Disorder: Systematic Review and Meta-Analysis. J Altern Complement Med. 2017 Dec;23(12):907-919.
REFG Menopause
REFG1 Laakmann E, Grajecki D, et al. Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review. Gynecol Endocrinol. 2012 Sep;28(9):703-709.
REFG2 Liu YR, Jiang YL, et al. Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety. Climacteric. 2014;17(4):325-335.
REFH Obsessive Compulsive Disorder
REFH1 Sarris J, Camfield D, et al. Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (OCD) and the OCD spectrum: a systematic review. J Affect Disord. 2012 May;138(3):213-221.
REFI Pregnancy
REFI1 Dante G, Pedrielli G, et al. Herb remedies during pregnancy: a systematic review of controlled clinical trials. J Matern Fetal Neonatal Med. 2013 Feb;26(3):306-312.
REFJ Premenstrual Syndrome
REFJ1 Dante G, Facchinetti F. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom Obstet Gynaecol. 2011 Mar;32(1):42-51.
REFK Safety
REFK1 Izzo AA. Interactions between herbs and conventional drugs: overview of the clinical data. Med Princ Pract. 2012;21(5):404-428.
REFK2 Tsai HH, Lin HW, et al. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-1078.
REFK3 Asher GN, Corbett AH, et al. Common Herbal Dietary Supplement-Drug Interactions. Am Fam Physician. 2017 Jul 15;96(2):101-107.
REFL Smoking Cessation
REFL1 Hughes JR, Stead LF, et al. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2014 Jan 8;(1):CD000031.
REFM Tooth Pain
REFM1 Raak C, Büssing A, et al. A systematic review and meta-analysis on the use of Hypericum perforatum (St. John’s Wort) for pain conditions in dental practice. Homeopathy. 2012;101(4):204-210.