What are the side‐effects of St John’s wort?
The use of St John’s wort as a treatment for depression has created some controversy,
with clinical trials into its safety and effectiveness constantly under review. Generally,
St John’s wort is well tolerated when taken on its own. The most common side‐effects
reported are dry mouth, dizziness, increased sensitivity to sunlight (photosensitivity),
gastrointestinal symptoms and fatigue. Its safety in pregnancy has not been clarified.
Purity of the active ingredients
While St John’s wort is freely available in Australia, the Therapeutic Goods
Administration has warned that the strength of the active ingredients may vary
between preparations, and potentially reduce the effectiveness of other medicines. A
problem with herbal remedies, compared to manufactured drugs, is that the dose of
the active ingredients cannot be precisely controlled.
Does St John’s wort affect other medications?
St John’s wort is known to adversely interact with some medications. Taken in
combination with other drugs, St John’s wort can boost the effect of the other drug,
which then increases the risk of negative reactions. St John’s wort may also impact on
the breakdown of other drugs by reducing their concentration levels in the blood and
hence their effect.
Contraindications can occur with interactions between St John’s wort and
antidepressants, HIV medications, transplant drugs, warfarin (a blood thinning agent),
some heart medications, anticonvulsants used in the treatment of epilepsy, the
contraceptive pill and migraine treatments.
St John’s wort should not be used in conjunction with antidepressant medication.
How does it work?
It is thought that St John’s wort is a reuptake inhibitor of serotonin, dopamine and
noradrenaline, which are chemicals in the brain that are linked to depression and
anxiety. Recent clinical trials have found that St John’s wort was superior to placebo,
or as effective as standard antidepressants (for example, Prozac, Tofranil and Zoloft).
Dosage
It is suggested that 900 mg of St John’s wort is required to effectively reduce
symptoms of non‐melancholic depression. As with other antidepressant medication,
the herbal remedy may take up to four weeks to become effective.
The use of St John’s wort as a treatment for depression has created some controversy,
with clinical trials into its safety and effectiveness constantly under review. Generally,
St John’s wort is well tolerated when taken on its own. The most common side‐effects
reported are dry mouth, dizziness, increased sensitivity to sunlight (photosensitivity),
gastrointestinal symptoms and fatigue. Its safety in pregnancy has not been clarified.
Purity of the active ingredients
While St John’s wort is freely available in Australia, the Therapeutic Goods
Administration has warned that the strength of the active ingredients may vary
between preparations, and potentially reduce the effectiveness of other medicines. A
problem with herbal remedies, compared to manufactured drugs, is that the dose of
the active ingredients cannot be precisely controlled.
Does St John’s wort affect other medications?
St John’s wort is known to adversely interact with some medications. Taken in
combination with other drugs, St John’s wort can boost the effect of the other drug,
which then increases the risk of negative reactions. St John’s wort may also impact on
the breakdown of other drugs by reducing their concentration levels in the blood and
hence their effect.
Contraindications can occur with interactions between St John’s wort and
antidepressants, HIV medications, transplant drugs, warfarin (a blood thinning agent),
some heart medications, anticonvulsants used in the treatment of epilepsy, the
contraceptive pill and migraine treatments.
St John’s wort should not be used in conjunction with antidepressant medication.
How does it work?
It is thought that St John’s wort is a reuptake inhibitor of serotonin, dopamine and
noradrenaline, which are chemicals in the brain that are linked to depression and
anxiety. Recent clinical trials have found that St John’s wort was superior to placebo,
or as effective as standard antidepressants (for example, Prozac, Tofranil and Zoloft).
Dosage
It is suggested that 900 mg of St John’s wort is required to effectively reduce
symptoms of non‐melancholic depression. As with other antidepressant medication,
the herbal remedy may take up to four weeks to become effective.
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