St. John's Wort

The prevailing view of St. John’s wort

 “Hypericum extracts [aka St. John’s Wort] are an “effective and safe tool in the hand[s] of qualified health professionals in primary care,” according to Professor Klaus Linde (photo) from the Centre for Complementary Medicine Research, at the Technical University of Munich, Germany.

Here’s what we know.

  • Dried alcoholic extracts are the most important preparations, although other preparations are available.
  • Depressive disorders are the best known and most widely studied use for St. John’s wort.
  • Studies show that Hypericum extracts are more effective than placebo and as effective as standard antidepressants.
  • In addition, it’s better tolerated during short-term treatment of major depression.
  • It’s also used to treat the more traditional, broader indication of psycho-vegetative disorders, depressive disorders, anxiety and/or nervous agitation.
  • The exact mechanisms of its action are unclear, but various bioactive constituents contribute to the clinical effects.
  • The most important risk associated with Hypericum extracts are interactions with other drugs.

The bottom line?
Professor Linde concludes, “If the risk of interactions is adequately taken into account, high quality Hypericum extracts are an effective and safe tool in the hand of qualified health professionals in primary care.”

An NIH-funded study reported that an extract of the herb St. John’s wort was no more effective for treating major depression of moderate severity than placebo. So, not everyone agrees with the professor’s conclusion.

However, a Cochrane review agrees with the professor’s view and concluded that the evidence suggests…

  • St. John’s wort is better than placebo to treat major depression.
  • It’s as effective as standard antidepressants.
  • It has fewer side effects than standard antidepressants.

4/9/09 20:38 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.