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MEDICAL CARE St. John’s Wort (Hypericum perforatum)
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What is St. John’s Wort?:
St. John’s Wort (Hypericum perforatum) is an herbal medicine that has historically been used for treating various mental disorders and physical ailments. Current research suggests that St. John’s Wort is useful in treating mild to moderate depression. The usefulness of St. John’s Wort as a primary treatment for anxiety has not been established. A 2005 study of the effectiveness of St. John’s Wort in treating social anxiety disorder (SAD) found that patients who took the medicine didn’t improve any more than patients who took a placebo.
If you have been diagnosed with SAD, you should consult with your healthcare professional about effective primary treatment methods, such as cognitive-behavioral therapy (CBT) or selective-serotonin reuptake inhibitors (SSRIs).
How is St. John’s Wort Taken?:
St. John’s Wort is usually taken daily in pill form.
What is the Dosage?:
In studies of SAD, the typical dosage ranges from 600 to 1800 milligrams of St. John’s Wort daily. However, because ingredients can vary, doses may also vary. Before taking St. John’s Wort, you should read the product label and discuss the dose with a qualified healthcare provider.
Who Shouldn’t Take St. John’s Wort? :
There is not enough scientific evidence to recommend the use of St. John’s Wort for children under 18 years of age or for women who are pregnant or breastfeeding. St. John’s Wort also has the potential to interact with many other medications, herbs and supplements and may not be recommended in those cases.
Medication Interactions:
St. John’s Wort interferes with the way the body processes or breaks down many medications, herbs and supplements. It may speed up or slow down this process causing increased or decreased effects, adverse reactions, or increased side effects.
The medications that may potentially interact with St. John’s Wort include, but are not limited to:
• birth control pills
• tricyclic antidepressants
• selective serotonin reuptake inhibitors (SSRIs)
• HIV drugs, such as Indinavir
• cancer drugs, such as Irinotecan
• Cyclosporine (used to prevent the body from rejecting transplanted organs)
• Digoxin (strengthens heart muscle contractions)
• Warfarin and related anticoagulants
In general, you should check the package insert and speak with a qualified healthcare professional and/or pharmacist about possible interactions.
What Are the Side Effects of St. John’s Wort?:
The most common side effects of St. John’s Wort are sensitivity to sunlight, restlessness or anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue/sedation, headache, sexual dysfunction, and skin reactions.
Generally only a small percentage of people will experience side effects, and the side effects tend to be less than those associated with standard antidepressant medication. You should speak with a healthcare provider immediately if you experience any side effects.
What Are the Risks Associated with St. John’s Wort?:
The U.S. Food and Drug Administration does not regulate the production of herbs and supplements. Although there are known medication interactions for St. John’s Wort, most herbs and supplements are not thoroughly tested. There is also no guarantee regarding the ingredients or safety of the product.
Sources:
Kobak KA, Taylor LVH, Warner G, Futterer R. St. John’s wort versus placebo in social phobia: Results from a placebo-controlled pilot study. Journal of Clinical Psychopharmacology. 2005; 25(1): 51-58.
National Center for Complementary and Alternative Medicine. Herbs at a glance: St. John’s Wort. Accessed Nov 24, 2007.
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