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By Boris M | 23 February, 2020 Published in Guides
2

You may have heard of St. John’s Wort and its uses as a natural remedy for antidepressants.

In fact, the blooms of St. John’s Wort has been used for this purpose by people for hundreds of years.

However, with any supplement, it’s always important to look at the research to see if it’s right for you.

Also, make sure the supplement is safe for you to take by talking to your doctor, as it can interact with a number of medications, reducing their effectiveness.

What is John’s Wort?

St. John’s Wort is an old home remedy mainly used for depression. It’s also used for other similar issues, such as anxiety and insomnia.

The plant itself grows yellow star-shaped flowers with 5 petals, and it’s named after John the Baptist. It was originally native to Europe, but it’s been transplanted to areas around the world.

Mainly, the blooms and flowers are used to make this remedy, though sometimes a few inches of the top of the plant are used, too.

In the past centuries, this supplement was used to treat many other disorders, up to and including malaria and nerve pain.

In addition, it has been used as a topical ointment to help heal injuries like cuts and bites. It was also noted to have soporific effects on patients.

Different Names for St. John’s Wort

“Wort” actually comes from an old word for “plant,” so St. John’s Wort just means St. John’s plant.

This name comes from the fact that it tends to bloom around St. John the Baptist’s feast day, so look for it to bloom somewhere near the end of June in most areas.

It’s known by other names, though, such as goatweed, tipton weed, and klamath weed.

If you’re looking for the plant to grow, check for the scientific name, Hypericum perforatum, to ensure you’re getting the right one. Sometimes, the medication is also referred to as “hypericum” for this reason.

The Effectiveness of St. John’s Wort on Depression

Many studies have been performed on the efficacy of St. John’s Wort. Some have concluded that it’s not as effective as other types of prescription antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) [1].

Other studies have shown more promise for this medication, finding that it works better than a placebo in fighting depression, often as well as prescription antidepressants [2].

More research is needed to be conclusive about its effectiveness. Like any medication, it’s efficacy often depends on the consumer.

You may find it works well for you to relieve symptoms of depression, when it doesn’t for others, while the reverse may also be true.

The Uses for St. John’s Wort

One of the main uses of St. John’s Wort is to treat depression. People have used it for this condition for centuries, which is why studies have been done on how effective it is in treating low mood.

Because it’s an over-the-counter medication, it’s more easily accessible for most people with this condition, which can be convenient.

However, if you’ve been diagnosed with clinical depression, whether mild, moderate, or severe, you should be under the care of a doctor so they can monitor your symptoms and progress.

St. John’s Wort is also commonly used to treat symptoms of anxiety, much like drugs like alprazolam. However, not as many studies have been done on the effectiveness of this medication for those with anxiety, so take it with caution.

This supplement is also used for conditions like mood swings and insomnia, though avoid taking it if you’ve been diagnosed with bipolar disorder, as it can increase psychosis.

Believed to work in a similar fashion to prescription antidepressants, it may help stabilize mood swings related to hormones, including ones that happen during menstrual cycles and menopause.

Others believe it can help with issues like attention deficit-hyperactivity disorder (ADHD), migraines, and hormonal imbalance.

However, not enough research has been done on the medication in relation to these issues to be conclusive either way, so always take it with caution.

The Problems Associated with Taking St. John’s Wort

Because St. John’s isn’t a prescription medication, it isn’t as regulated by the FDA as prescription medications are.

What that means is the company manufacturing the medication oversees its own supplement, ensuring the proper amount of the herbal remedy is in the package.

In fact, they don’t even have to submit to the FDA for approval before it’s sold to consumers.

Unless the FDA gets reports about a certain supplement or brand, they typically do not look into safety issues with supplements.

Therefore, it’s imperative that you trust the brand when buying St. John’s Wort [3]. Look for companies that employ independent testing of their products or ask your doctor or pharmacist for a recommendation.

One of the main issues with this medication is that it works to break down other medications more quickly. While that may not sound like a problem, it can cause issues when you’re on treatments for chronic conditions.

For instance, if it breaks down a drug like warfarin more quickly, that means that you won’t have that drug in your system after a certain period of time, and it won’t be treating you like it should.

Beginning to Take St. John’s Wort

Discuss taking this medication with your doctor before you begin it. They will want to know you’re on it, so they can check for interactions with any other medications you’re currently taking.

In addition, they may want to offer alternatives based on what they know about your medical history, including making recommendations for a therapist, trying anti-depressants, or using a different type of mood stabilizer, particularly if you’re bipolar.

When beginning this medication, ask your doctor about dosing. Typically, 900 milligrams per day is a recommended dose, but you may want to start with a smaller amount and gradually work your way up to this dose.

Split up your dose throughout the day, such as 250 milligrams twice a day for a smaller dose or 300 milligrams three times a day for a larger one.

Taking Precautions When Using St. John’s Wort

Check your blood pressure regularly while taking St. John’s Wort. In some people, it can cause high blood pressure.

If you don’t have a blood pressure monitor at home, try visiting a local pharmacy, as many have blood pressure monitors for their customers’ use.

If you notice your blood pressure numbers are increasing, you may need to discontinue this supplement, so talk to your doctor.

Always tell new doctors you’re taking this medication, even though it’s not a prescription medication, including dentists and mental health experts. That way, they can monitor possible interactions with other medications.

Be cautious about going out in the sun while taking this supplement. Always wear sunscreen and stick to the shade when possible, as it can make you more sensitive to daylight, leading to severe sunburns.

Also, don’t stop any antidepressants you’re on to take St. John’s Wort. Stopping antidepressants quickly can give you unpleasant withdrawal symptoms.

If you’re on an antidepressant and want to take St. John’s Wort, talk to your doctor first, as they may recommend weaning off of your antidepressant.

Interactions with St. John’s Wort

Many consider St. John’s Wort safe to use because it’s “natural,” but it’s not safe to use without checking with your doctor or pharmacist first.

It has major interactions with drugs like alprazolam, birth control pills, warfarin, and prescription antidepressants, just to name a few.

HIV medications are also typically affected by this supplement [4]. Anti-convulsants, anti-coagulants, and anti-cancer drugs may also have possible interactions.

Often, St. John’s Wort decreases the effectiveness of other medications by breaking them down more quickly, including warfarin, alprazolam, and birth control medications.

Then, you don’t have the drug in your system when you need it. In the case of antidepressants, it works in a similar fashion to increase serotonin in the brain, leading to too much serotonin.

While that sounds like a good thing, it’s really not, as it can cause major issues and side-effects, such as heart problems and increased anxiety.

Watching for Potential Side Effects

Like any medication or supplement, St. John’s Wort can have side effects. In some people, it can increase anxiety and agitation.

Even though it’s used to treat insomnia, it can actually cause this symptom in some people; just like antidepressants, one supplement is not going to work for everyone.

You may also experience more intense dreams and restlessness.

Additionally, it may cause symptoms like stomach pain and diarrhoea, low blood sugar levels, tiredness, dizzy spells, and more sensitivity to daylight.

Some side effects may wear off after you’ve been on the medication for several weeks, but if your side effects are severe, talk to your doctor about stopping the supplement.

However, some studies suggest that St. John’s Wort is safer than taking many prescription medications, even with the potential side effects [5].

Many people present with fewer side effects on St. John’s Wort than on similar antidepressants, though of course, the side effects depend on the person.

Knowing When to Avoid St. John’s Wort

Don’t try to take this medication if you’ve been diagnosed with bipolar disorder.

In some people, it can increase instances of mania [6]. Also, as noted, avoid taking this medication with other antidepressants, as it can lead to too much serotonin and unwanted side effects [7].

Like many supplements, St. John’s Wort hasn’t been extensively tested on pregnant women.

It may be associated with a lower weight for the baby at birth, though testing in animals hasn’t shown any other major side effects for the baby. Always take any medication with caution while pregnant.

Weaning Off St. John’s Wort

As with many medications that affect the brain, you may experience withdrawal symptoms when quitting St. John’s Wort.

If you want to stop taking this medication, try gradually reducing your dose over a couple of weeks. That will help wean you off of the medication.

This type of weaning may be especially beneficial if you have been taking this medication for a month or longer.

You may experience dizzy spells, agitation, and anxiety when trying to get off this medication. You may also notice a recurrence of depression if you were taking it to relieve this issue.

Treating Conditions Besides Depression

Even if you haven’t been diagnosed with clinical depression, you may find this treatment beneficial when experiencing periods of low mood due to things out of your control.

While St. John’s Wort is most often used to treat depression, you can try it out for other conditions. 

For instance, some people have periods of depression when they are being treated for cancer, which is a natural reaction, and St. John’s Wort may help.

However, always talk to your doctor before taking this medication, particularly if you are being treated for a condition like cancer.

Similarly, some people take it for seasonal affective disorder (SAD), a condition that causes low mood due to lack of sunlight in the winter.

Other people find it helps when trying to quit smoking. It may help you quit simply by helping to stabilize your moods while weaning yourself off cigarettes.

While not much research has been done on this use, it typically will not harm you to try it, as long as you’re not taking other medications it will interact with.

Begin taking it a week before you want to start weaning yourself off of cigarettes and continue to take it throughout the process of quitting.

As noted, St. John’s Wort can be used to help treat mood problems related to hormonal changes, such as during a menstrual cycle or menopause.

In addition, it may also help relieve other related symptoms, as well, such as hot flashes. However, the research suggests this is most effective if this supplement is used together with another supplement, black cohosh [8] .

If you’re experiencing symptoms related to menopause, discuss this combination with your doctor to see if it’s a good fit for you.

References

[1] https://www.ncbi.nlm.nih.gov/pubmed/21632064

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946846/

[3] https://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx

[4] https://www.ncbi.nlm.nih.gov/pubmed/15350151

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946846/

[6] https://www.ncbi.nlm.nih.gov/pubmed/21120109?dopt=Abstract

[7] https://www.ncbi.nlm.nih.gov/pubmed/15049433?dopt=Abstract

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628120/

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