Can St. John’s wort products help?

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Some St. John’s wort products can relieve mild to moderate in the short term. They haven't been proven to have the same effect in severe , though. Side effects are less common with St. John’s wort products than they are with some other antidepressants. But interactions with other drugs can occur.

Depression isn't the same as just feeling sad or down. The typical signs of include feeling very down for at least two weeks, along with a general lack of interest or motivation. People who are depressed usually sleep poorly, feel exhausted and have problems coping in everyday life. They lose their self-confidence, have a very negative self-image and often become withdrawn. They also have difficulty concentrating. Depression can be treated with psychological treatment and/or medication (antidepressants).

Treating depression with St. John's wort products

People with milder cases of often use herbal remedies with St. John's wort extracts in them. Some products that contain St. John's wort use the Latin name for it: Hypericum perforatum, or simply hypericum.

As with most herbal medicines (phytopharmaceuticals), there are many different St. John's wort products on the market, with very different doses and ingredients. A lot of these products only have a very small dose of hypericum in them. This means that different products may have different effects, and won't necessarily work like the products tested in the studies did.

St. John’s wort products for moderate have to be prescribed by a doctor. But no prescription is needed for products to treat mild depressive mood disorder.

Research on the effectiveness of St. John's wort

A group of researchers analyzed a total of 35 studies involving nearly 7,000 participants. They wanted to find out whether St. John's wort products can relieve the symptoms of in adults, and how they compare to other medications. The studies lasted at least four weeks and tested a wide range of St. John's wort products. In most of these studies the participants used St. John's wort at doses of between 500 mg and 1,200 mg per day. The study participants had mild to moderate . The majority of them were women.

Effectiveness in mild to moderate depression

The St. John's wort products used in the studies were found to relieve mild to moderate better than the placebo treatment did. Studies that compared St. John's wort with other antidepressants showed that the treatments were similarly effective.

Only few of the studies lasted more than eight weeks. But often lasts longer than that or comes back after a while. There isn't enough research on whether St. John's wort products are effective over the long term or can prevent further episodes of .

The researchers found no that St. John's wort helps in severe . Severe is a very serious disease and should not be treated with St. John's wort alone.

Side effects and interactions with other medications

St. John's wort products can cause side effects such as nausea, minor skin irritations, sensitivity to light (photosensitivity) and headaches. They may trigger allergic reactions too. But the side effects are somewhat less common than those of other antidepressants.

Interactions with medications may occur when St. John's wort products are used – that means that they could increase or decrease the effect of other medications taken at the same time. For instance, St. John's wort reduces the effect of medicines that slow down blood clotting or suppress the body's . And there's some that it can make birth control pills less reliable.

Like conventional medicines, plant-based medicines such as St. John's wort may cause problems when used together with other medications. So it's important to be aware of possible interactions when taking more than one medication – and to not take over-the-counter medicine without consulting your doctor.

Apaydin EA, Maher AR, Shanman R, Booth MS, Miles JN, Sorbero ME et al. A systematic review of St. John's wort for major depressive disorder. Syst Rev 2016; 5(1): 148.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on June 23, 2020
Next planned update: 2023

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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