Is St. John's Wort safe?

Introduction

St. John's Wort (Hypericum perforatum) is a widely used herbal remedy, particularly for treating mild to moderate depression. Despite its popularity, questions about its safety, especially concerning drug interactions and use during breastfeeding, remain pertinent.

Key Insights

Efficacy and Tolerability in Depression:
- St. John's Wort is effective for mild to moderate depression, showing comparable efficacy to standard SSRIs with fewer discontinuations due to side effects .
- It is well-tolerated in monotherapy, with a good safety profile over long-term use .
Drug Interactions:
- St. John's Wort can induce the cytochrome P450 (CYP) 3A4 enzyme and P-glycoprotein, reducing the efficacy of co-administered drugs metabolized by these pathways, such as HIV protease inhibitors, immunosuppressants, and certain anticancer drugs .
- It can also impair the efficacy of hormonal contraceptives, leading to unwanted pregnancies .
- Combining St. John's Wort with other serotonergic agents or antidepressants can lead to central pharmacodynamic interactions, such as serotonin syndrome .
Safety During Breastfeeding:
- St. John's Wort is excreted into breast milk at low levels, with hyperforin being the primary detectable component. However, it is present at very low concentrations in infants' plasma, suggesting minimal exposure .
- Some minor adverse effects, such as colic and drowsiness, have been reported in breastfed infants, but these were not statistically significant compared to control groups .

Conclusion

St. John's Wort is a safe and effective treatment for mild to moderate depression, with a favorable tolerability profile. However, it can interact with various medications by inducing the CYP3A4 enzyme and P-glycoprotein, potentially reducing the efficacy of these drugs. While it appears relatively safe during breastfeeding, with minimal infant exposure to its active components, further long-term studies are needed to fully understand its safety profile in this context.

Is St. John's Wort safe?

Summary

Consensus Meter

Introduction

Key Insights

Conclusion

Sources and full results

St. John's wort and depression: efficacy, safety and tolerability-an update.

St. John's wort is a safe and effective antidepressant for mild to moderate depression, but its use may affect other prescribed medications due to its potential to potentate certain enzymes in the cytochrome P450 enzyme system.

Drug Interactions with St John’s Wort

St John's Wort may reduce the efficacy of co-medications, but with proper precautions and contraindications, quality-tested products can be used safely and effectively for mild to moderate depressive disorders.

Drug interactions with St John's wort : mechanisms and clinical implications.

St John's wort may reduce the efficacy of co-medications, but with proper precautions and contraindications, quality-tested products can be used safely and effectively for mild to moderate depressive disorders.

The safety of St. John's wort (Hypericum perforatum) during breastfeeding.

St. John's wort is safe for breastfeeding mothers and their infants, with no significant differences in maternal or infant demographics or adverse events.

Pharmacokinetic Interactions of Drugs with St John’s Wort

St John's Wort may interact with various drugs, causing potential safety concerns and requiring further research on herb-drug interactions.

Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis.

St John's wort has comparable efficacy and safety compared to SSRIs for patients with mild-to-moderate depression.

Long-term effects of St. John's wort (Hypericum perforatum) treatment: a 1-year safety study in mild to moderate depression.

St. John's wort extract ZE 117 is a safe and effective treatment for mild to moderate depression over long periods, especially suitable for relapse prevention.

Herb–Drug Interactions with St John’s Wort (Hypericum perforatum): an Update on Clinical Observations

St John's Wort may interact with certain drugs, potentially causing serious side effects or even death, and its safety profile is generally encouraging, but interactions with certain drugs should be considered.

St. John's wort (Hypericum perforatum) and breastfeeding: plasma and breast milk concentrations of hyperforin for 5 mothers and 2 infants.

St. John's wort is relatively safe for breastfeeding, with low levels of hyperforin in breast milk and no observed side effects in mothers or infants.

St. John's wort (Hypericum perforatum)--is it safe during breastfeeding?

St. John's wort is safe for use during breastfeeding, with only low levels of active components found in breast milk and no side effects observed in mother or infant.

Try another search