St. John's Wort
- St. John's wort is an herbal preparation most commonly used for the treatment
of mild depression or simply as a mood elevator.† It is also used in the treatment
of anxiety, stomach upset, insomnia, fluid retention, and hemorrhoids.
- St. John's wort has been used topically in the treatment of nerve and muscle
pain, skin inflammation, skin wounds, and burns.
- St. John's wort is also known as Hypericum perforatum, klamath weed, John's
wort, amber touch-and-heal, goatweed, rosin rose, and milleperituis.
- Like most herbal preparations, St. John's wort has not been evaluated by
the FDA for safety, effectiveness, or purity. All potential risks and/or advantages
of St. John's wort may not be known. Additionally, there are no regulated
manufacturing standards in place for these compounds. There have been instances
where herbal/health supplements have been sold that were contaminated with
toxic metals or other drugs. Herbal/health supplements should be purchased
from a reliable source to minimize the risk of contamination.
- When considering the use of any herbal supplements, consultation with a
primary health care professional is advisable. Additionally, consultation
with a practitioner trained in the uses of herbal/health supplements may be
beneficial, and coordination of treatment among all health care providers
involved may be advantageous.
- As with most herbal supplements, the effects of St. John's wort on pregnancy
and nursing are unknown.
- It is estimated that one out of every five people taking prescription anti-depressants
are also taking St. John's wort with the hopes of further improvement.†
According to a recent study presented at the American Association of Pharmaceutical
Scientists meeting, 2000, using St. John's wort may actually decrease the
effectiveness of prescription antidepressants.
This study also showed that many other prescription and over-the-counter medications
become less effective or even ineffective when combined with St. John's wort.
Birth control pills are one glaring example.† Other medicines that may be
affected by using St. John's wort simultaneously are:
- † Monoamine oxidase inhibitors, such as tranylcypromine (Nardil), phenelzine
(Parnate), or isocarboxazid (Marplan)
- Selective serotonin reuptake inhibitors, such as citalopram (Celexa), fluvoxamine
(Luvox), fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft)
- Tricyclic antidepressants, such as amitriptyline (Elavil), amoxapine (Asendin),
clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine
(Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine
- Bupropion (Wellbutrin, Zyban)
- Trazodone (Desyrel) or nefazodone (Serzone)
- Venlafaxine (Effexor)
- Mirtazapine (Remeron)
- HIV/AIDS protease inhibitors, such as indinavir (Crixivan), amprenavir (Agenerase),
nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Fortovase, Invirase)
- HIV/AIDS nonnucleoside reverse transcriptase inhibitors, such as delavirdine
(Rescriptor), efavirenz (Sustiva), or nevirapine (Viramune).
Many people who take St. John's Wort are not aware that it has side effects
just like any other medication.† An important summer warning: If you take
St. John's wort, avoid prolonged sun exposure. St. John's wort may increase
your skin's sun sensitivity.
- St. John's wort is a blood thinner and can affect your blood's ability to
clot. Be sure to discontinue use before you have surgery of any kind and inform
your healthcare provider that you have been taking St. John's wort.
Other side effects: Although uncommon, allergic reactions to St. John's
wort have been reported. Stop taking St. John's wort and seek emergency
medical attention if you experience allergic symptoms including difficulty
breathing; throat tightness; facial/lip swelling; or hives.† Other side
effects may† include:† rash, abdominal fullness, constipation.
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Created: 4/26/2001  - Donnica Moore, M.D.