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| St. John’s Wort | ||
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Hypericum perforatum |
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A popular herb with anti-depressant,
anti-spasmodic, anti-inflammatory & anti-viral
actions used to treat mild depression, anxiety, headaches, & nerve
pain such as sciatica. |
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| There are over 400 known species of the genus Hypericum of the Hypericaceae (Guttiferae) family. The ancient Greeks knew of St. John’s wort’s anti-depressive and psychotropic properties and it has since become very famous in modern times for treating mild depression, anxiety, mania, bipolar affective disorder, and schizophrenia. Hypericum is an excellent remedy for treating all types of burns and topical wounds. It is commonly used for treating neuralgia and nerve pain such as that associated with sciatica, and is known to contain anti-viral and anti-inflammatory compounds. Clinical studies have shown St. John’s wort to be as effective as conventional synthetic antidepressants for treatment of mild to moderate depression. St. John’s wort consists of a complex mixture of over two dozen constituents including the acylphloroglucinol, hyperforin, the naphthodianthrone derivatives hypericin and pseudohypericin, as well as a number of flavonoids and proanthocyanidins. As with other antidepressant drugs, observation of the therapeutic effects of St. John’s wort may require 2 to 4 weeks of therapy. Recent research on St. John’s wort has shown it to be active in several behavioral models of depression. Its mechanism of action has been attributed to the ability of hyperforin to inhibit synaptosomal uptake of several neurotransmitters that are associated with moodiness when concentrations become low, including serotonin, dopamine, norepinephrine, gamma-aminobutyric acid, and L-glutamate. This mechanism may be associated with changes in ionic conductance pathways. The clinical effects have been correlated with the hyperforin content. Adverse reactions range from allergic reactions, minor gastrointestinal disturbances, and photosensitivity in sensitive patients, although these reactions have been rare and mild. However, St. John’s wort has been reported to promote the metabolism of coadministered drugs metabolized by cytochrome P450 enzyme family 3A4, which metabolize many drugs including oral contraceptives, theophylline, digoxin, warfarin, HIV protease inhibitors, and cyclosporin. For patients taking drugs metabolized by cytochrome P450 3A4, risk-benefit of concomitant therapy with St. John’s wort should be carefully considered prior to treatment. Concomitant use with other anti-depressant medications is not recommended, unless under medical supervision. St. John’s wort should be discontinued during pregnancy and breastfeeding. |