St. John’s Wort
St. John’s wort is a well-known herb used for mood support in mild to moderate low mood. It can be effective for some people, but it also has one of the longest interaction lists in herbal medicine because it can speed up how the liver processes many medications. This is a ‘use with respect’ herb.
Key Benefits
- May support mood balance in mild to moderate low mood for some individuals
- Traditionally used for nervous tension and stress resilience
- Some people report improved sleep quality when mood improves
Common Issues It May Help With
- Mild to moderate low mood
- Stress-related nervous tension
- Occasional sleep disruption related to mood
How To Use (Simple)
- Most studied forms are standardized extracts. Follow label directions carefully and use consistently for several weeks before judging effects. If you are on ANY prescription medication, check interactions first and consult a clinician/pharmacist.
Taste / Notes
Tea: bitter and resinous; many people prefer capsules/extract.
Evidence Level
Moderate-to-strong evidence for mild to moderate depression compared to placebo in some studies, but results vary by extract and study quality. Interaction risks are well established.
Cautions
HIGH CAUTION: Major drug interaction potential. Can cause sun sensitivity (photosensitivity), GI upset, dry mouth, dizziness, agitation, or insomnia. Avoid if you have bipolar disorder (may trigger mania). Do not combine with other serotonergic agents without clinician guidance. Stop and seek help if mood worsens or you have suicidal thoughts.
Interactions
Strongly interacts with many medications by inducing CYP enzymes and P-gp, potentially lowering drug levels: antidepressants, birth control pills, warfarin, cyclosporine/tacrolimus, HIV meds, hepatitis C antivirals, many seizure meds, and others Do NOT combine with SSRIs/SNRIs/MAOIs/triptans or other serotonergic agents without clinician supervision (risk of serotonin syndrome) May reduce effectiveness of hormonal contraceptives (breakthrough bleeding and pregnancy risk) Can alter effects of anticoagulants (e.g., warfarin) — requires clinician monitoring
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