St. John’s Wort is the common name for hypericum perforatum, an herbal remedy for the treatment of depression that has become increasingly popular over the past decade in the United States. It is widely used throughout Europe, Germany in particular, where it is licensed for depression, sleep disorders and anxiety. Herbal remedies are considered a form of alternative medicine.
St. John’s Wort is a yellow flower with five petals that grows wild in many parts of the world. It is named for St. John the Baptist because it blooms around June 24, his feast day. In ancient times, this herbal remedy was believed to have powers to ward off evil spirits.
Treating depression is the most common use for St. John’s Wort. It is also believed by some to be therapeutic in various neurological and immunological disorders (including HIV/AIDS). The mechanism of action is only partially understood at this time and is similar to the prescription medications known as serotonin reuptake inhibitors. Familiar drugs of this class of antidepressants are Paxil, Zoloft, and Prozac.
In some clinical trials, St. John’s Wort has demonstrated effectiveness as an antidepressant when compared to a placebo (sugar pill) or doses of many types of antidepressants. Dozens of research studies have been conducted and published throughout the world on the efficacy of this herb. Although some studies have not shown efficacy for St. John’s Wort, these studies are in the minority and have design issues (for instance, the linked study also showed no positive effect of an FDA-approved antidepressant medication on study participants).
In early 2005, the British Medical Journal published an article demonstrating that in a large clinical trial, St. John’s Wort is at least as effective as a commonly-prescribed antidepressant and has fewer side effects in the treatment of moderate to severe major depression (BMJ 2005;330:503 (5 March)). In 2008, the Cochrane Collaboration — a non-profit research organization that analyzes scientific studies to draw conclusions from them — determined that the overall body of research evidence for the effectiveness of St. John’s Wort in the treatment of depression was strong.
Cochrane Researchers reviewed 29 trials which together included 5,489 patients with symptoms of major depression. All trials employed the commonly used Hamilton Rating Scale for Depression to assess the severity of depression. In trials comparing St. John’s wort to other remedies, not only were the plant extracts considered to be equally effective, but fewer patients dropped out of trials due to adverse effects.