To share this page ↑
author: Dr. Kevin Curran
Background on St. John’s Wort
St. John’s wort (Hypericum perforatum) is a small herb with yellow flowers. Originally native to Europe, this herb now grows wild across most of the temperate regions of the world. You can find St. John’s wort growing happily in meadows and along roadsides in the United States. This popular plant has gained in popularity due to the use of St. John’s wort for depression and a few other health issues.
St. John’s wort for depression
Depression is more than just a brief feeling of sadness. Depression is a mental health problem that persistently lowers your mood and prevents you from engaging with the world in a positive manner. Approximately, 7-10% of the U.S. population suffered from depression in the past year.
As you may imagine, its difficult to generalize about the causes for depression since each person carries with them their own personal history and their own current life situation. And perhaps most importantly, each depressed individual has their own unique brain, which contains approximately 100 billion neurons, making about 100 trillion connections with other neurons. The exact nature of this neural wiring will be unique to each individual.
All of this variation among individuals makes treating depression a challenge. For most people, relief comes in the form of some combination of psychotherapy, lifestyle choice and medication.
Here, at EthnoHerbalist, we research the medicinal plants that can address health issues. These plants often act on our bodies by adjusting the same biological pathways that traditional pharmaceutical drugs act upon.
For cases of mild to moderate depression, clinical data has demonstrated that the use of St. John’s wort is a very reasonable therapy (Harrer, 1994; Klemow, 2011; Martinez, 1994; Nathan, 2001; Schrader, 1998).
This ancient plant has offered relief to many depressed individuals.
The Cochrane Collaboration performed a meta-analysis of the clinical efficacy of taking St. John’s wort to treat mild to moderate depression (Berner, 2009). A meta-analysis is a thorough scientific summary of a large number of separate, high-quality clinical trials. The Cochrane meta-analysis combined the results from 29 trials which, collectively, tested the effect of St. John’s wort on 5,000 depressed individuals.
The overall conclusion from this meta-analyses states that taking St. John’s wort is an effective remedy for mild to moderate depression.
Medicating with St. John’s wort resulted in an overall improvement of mood and a decrease in the anxiety and insomnia that are often related to depression. Surprisingly, St. John’s wort proved to be just as effective as taking a prescription anti-depressant (Prozac, Zoloft, Celexa, ext.)
Due in part to the strength of such results, the American College of Physicians now suggest that St. John’s wort be considered a treatment option along with prescription antidepressants (SSRIs or trycyclic anti-depressants). Similarly, Commission E, the German government organization that performs rigorous studies on medicinal plants, recommends prescribing St. John’s wort for mild to moderate depression in children and adolescents (Blumenthal, 1998). An additional benefit to using St. John’s wort is that you avoid the side effects associated with SSRI prescription anti-depressants, such as weight gain and sexual issues.
That being said, if you are contemplating using St. John’s wort for the first time, you should be aware that not all people report improvements. A separate clinical summary (Linde, 2005) reported that St. John’s wort is not a proven therapy for depression and performs no better than a placebo control. However, it should also be noted that in some of these negative result studies, the clinicians found that prescription anti-depressants also failed to alleviate depression. This lack of consistency in clinical results for psychological medications is, in large part, due to the above mentioned variation that exists in each individual and their own specific case of depression.
What works for one person may not work for everyone.
Factors to consider when choosing the best brand of St. John’s wort supplement.
Before taking St. John’s wort, the most important factor to consider is the possibility for drug-drug interactions. St. John’s wort is known to interact with other medications in a way that may reduce their effectiveness. For example, if you are taking birth control pills while simultaneously taking St. John’s wort, there is a possibility the St. John’s wort will decrease the effectiveness of the birth control pills. If you use other medications, please consult your physician before taking St. John’s wort.
Once you’ve determined St. John’s wort is an appropriate choice, you then need to consider which is the best St John’s wort brand to use.
First of all, you should only purchase a St. John’s wort supplement that lists a specific amount (mg.) of Hypericum perforatum on their label. Your brand should also state a specific amount (mg.) of either hypericin or hyperforin. Both are chemical messengers that help regulate the neurotransmitter pathways in your nervous system (serotonin, dopamine, ext.). These biologically active chemicals are found in St. John’s wort and scientists believe they are responsible for delivering the health benefits (Nathan, 2001; Suzuki, 1984).
In general, the implication is that supplement brands whom list these compounds on their labels have actively taken steps to ensure a potent form of St. John’s wort is in each capsule.
IMPORTANT NEW INFORMATION
In 2015, investigations in New York and in Canada exposed the fraudulence of certain herbal supplement brands. Some of the popular big box stores (Walmart, GNC, Target, ext.) are allegedly selling St. John’s wort capsules that don’t contain any St. John’s wort plant material. Instead, the capsules contain wheat or rice powder. This story is still unfolding and involves some debate about DNA barcoding. We will provide updates when available.
More recently, in February of 2016, a British government agency announced the recall of 6 batches of St. John’s wort. The Medicines and Healthcare products Regulatory Agency (MHRA) warned British consumers about the presence of toxins in certain brands of St. John’s wort. The toxins are called pyrrolizidine alkaloids (PAs). These chemicals are not naturally found in St. John’s wort. Therefore, the recalled batches were contaminated with nearby weeds during harvesting. The 6 recalled batches (91,800 pills) were marketed under 3 different brand names (HRI Good Mood, Asda St. John’s wort and Superdrug St. John’s wort). This situation is confined to England, but if you would like more information, here’s a link to the relevant British agency website.
These are both unfortunate situations. However, its important to remember that these quality control issues are only occurring in a handful of brands. As a consumer, you get to decide where you buy your supplements.
Which St. John’s wort brand is the most effective?
Here, at EthnoHerbalist, we perform market research to find high-quality supplements from respectable companies. Each of the brands listed below are manufactured by legitimate U.S. companies with strict farming and manufacturing standards. Each company also performs purification tests on their plant extracts to confirm that a clean and potent form of St. John’s wort is in each capsule..
Remember to bookmark this page! We will continue to update this article with new health reports and clinical results regarding the use of St. John’s wort for depression.
I spend a lot of time chatting with plant growers and supplement industry folks, sometimes I hear about cool stuff that’s given away as free trial offers. Onnit, a supplement company that I respect, is currently giving away free bottles of an interesting supplement called New Mood.
Serotonin is a key neurotransmitter linked to our mood, happiness, and positive outlook. New Mood naturally boosts serotonin levels in our brain. St. John’s wort acts in a somewhat similar way, that’s why I’m mentioning the offer on this page.
You can click on the adjacent image to learn more. But in a nutshell, New Mood capsules contain the raw building blocks of serotonin (L-Tryptophan, 5-HTP, Vitamin B6). So, the idea is that by ingesting the serotonin building blocks, you enhance your brain’s ability to naturally produce it’s own serotonin levels. My girlfriend and I have been using these and we definitely notice an effect.
Onnit is a sophisticated fitness and supplement company, based in Austin, Texas. In the past 5 years, this company has earned a lot of love from the healthy living community. They’ve quickly developed a devout and loyal fan-base.
The statements regarding New Mood have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Berner LK, Kriston MM. “St. John’s wort for treating depression”. 2009. The Cochrane Collection. http://www.cochrane.org/CD000448/DEPRESSN_st.-johns-wort-for-treating-depression.
Blumenthal M. “The complete German Commission E monographs: therapeutic guide to herbal medicines”. Austin: American Botanical Council, 1998, and Boston: Integrative Medicine Communications, 1998.
Harrer G, Hubner,WD, and Podzuweit H. “Effectiveness and tolerance of the hypericum extract LI 160 compared to maprotiline: a multicenter double-blind study”. J.Geriatr.Psychiatry Neurol. 1994;7 Suppl 1:S24-S28.
Klemow KM, Bartlow A, Crawford J, Kocher N, Shah J, Ritsick M. “Chapter 11: Medical Attributes of reputable St. John’s Wort (Hypericum perforatum)”. 2011. In Benzie IFF, Sissi WG. Herbal Medicine Biomolecular and Clinical Aspects. (2nd ed. ed.). CRC Press.ISBN 9781439807163.
Linde K, Berner M, Egger M, Mulrow C. “St John’s wort for depression: Meta-analysis of randomised controlled trials”. British Journal of Psychiatry. 2005. 10.1192/bjp.186.2.99.
Martinez B, Kasper S, Ruhrmann S, and Moller H. J. “Hypericum in the treatment of seasonal affective disorders”. J Geriatr.Psychiatry Neurol. best brand of st. johns wort, 1994;7 Suppl 1:S29-S33.
Nathan PJ. “Hypericum perforatum (best st john’s wort brand): a non-selective reuptake inhibitor? A review of the recent advances in its pharmacology”. J. Psychopharmacol. (Oxford) 15 (1) 2001: 47–54.
Schrader E, Meier B, and Brattstrom A. “Hypericum treatment of mild-moderate depression in a placebo-controlled study. A prospective, double-blind, randomized, placebo-controlled, multicentre study”. Human Psychopharm. 1998;13:163-169.
Suzuki O, Katsumata Y, Oya M, Bladt S, and Wagner H. “Inhibition of monoamine oxidase by hypericin”. Planta Med. 1984;50:272-274.