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How Much St John’s Wort Should I Take For Depression

Can St Johns Wort Help With Depression

Should You Use St. John’s Wort for Depression?

The research on whether St. Johns Wort effectively treats depression is mixed.

Some experts say St. Johns wort seems to reduce the severity of depression symptoms. But more research is needed before we truly know how effective the supplement is.

The NCCIH cites a 2008 review of 29 international studies that suggested that St. Johns wort may be better than a placebo and as effective as different standard prescription antidepressants for major depression of mild to moderate severity.

However, a 2011 NCCIH and NIMH-funded clinical trial with 73 participants found that St. Johns wort and an antidepressant called citalopram decreased symptoms of minor depression the same amount as a placebo.

Also, a 2016 systematic review of St. Johns wort for major depressive disorder found that the supplement was more effective than a placebo for mild and moderate depression. But it should be noted that this research did not include results for severe depression.

Based on this research, the effectiveness of St. Johns wort may vary between people and research studies. A good next step would be consulting with your doctor or psychiatrist to see what option is best for you, especially if youre looking for a natural remedy.

Use In Children Vs Adults

Studies that look at how a medication works for adults can’t always be used to show how it would work in children. There are many factors that determine how a medication or supplement might affect a child, and it’s not necessarily as simple as giving them a lower dose of a drug because they are smaller than an adult.

One example of this phenomenon is the use of prescription antidepressant medications in children. A potential danger of antidepressant use in people under the age of 25 is an increase in suicidal thoughts or behavior. While the side effect is uncommon, it was significant enough that the FDA put a black box warning on all prescription antidepressants.

It’s unclear if natural and herbal supplements could carry the same risk. But if St. John’s wort can alter neurotransmitters in a way that’s similar to how antidepressant medications work, the question would be of valid concern for researchers, medical professionals, alternative medicine practitioners, and anyone considering using it.

It’s important to remember that a diagnosis of depression alone is associated with a higher risk of suicide, regardless of treatment. If someone you love is depressed, make sure you know the warning signs of suicide.

If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

St Johns Wort And Serotonin Syndrome

Cytochrome P450 3A4 is a liver enzyme whose job is to oxidize small, foreign organic molecules and toxins so they can be removed from your body.

Some substances, including St. Johns wort and grapefruit juice, affect the enzyme CYP3A4. And can amplify or weaken the action of those drugs and nootropics.

St. Johns wort interacts with tricyclic, SSRI and MAOI antidepressants. Taking St. Johns wort with these medications increases their action, and could lead to serotonin syndrome which can be deadly.

Do not take St. Johns wort with antidepressants including:

  • Tricyclic: Amitriptyline , nortriptyline , imipramine
  • SSRI: Citalopram , escitalopram , fluvoxamine , paroxetine , fluoxetine , sertraline
  • MAOIs: , tranylcypromine

St. Johns wort can reduce levels of antihistamines in your body. It can increase the risk of bleeding when combined with Plavix and birth control pills. Do not use St. Johns wort with Warfarin as it can reduce its effectiveness.

Drugs that suppress the immune system can lose their effectiveness with St. Johns wort. It should not be used with drugs that treat HIV and AIDS.

St. Johns wort can increase the sedative effect of barbiturates, benzodiazepines , and triptans that treat migraines.

St. Johns wort also interacts with antifungal drugs, statins, calcium channel blockers, and any other medication that is broken down by the liver. Which covers a lot of drugs and nootropics.

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Can St John’s Wort Help With Depression And Anxiety

There is a large body of clinical evidence that supports St Johns wort use for depression and anxiety. The German Commission E approved a standardised St Johns wort extract to officially support low to moderate mood issues and it is one of the most studied and prescribed plants in complementary medicines today.If you struggle with your mood and are wondering how to take St Johns wort, then a St Johns wort supplementcould be the perfect solution. A multitude of studies have highlighted its efficacy and also the lack of side effects that people experience when taking this amazing plant.

How Things Go Bad

Natural Help for Sadness and Depression

Depression can be experienced at any age. Imbalances in neurotransmitters including serotonin, dopamine, and norepinephrine can affect everything from cognition to mood.

Memory, recall, reaction time and mood diminish

Anxiety, panic attacks, stress and insomnia rise

Neuroplasticity declines degrading long-term potentiation

Under conditions of depression and chronic stress your brain loses the capacity to transmit signals between neurons efficiently. Memory, cognition, and all suffer as a result.

Read Also: National Institute Of Mental Health Depression

How Does St John’s Wort Work

Once youve learnt how to take St Johns wort, youll probably be wondering how it works. This plant works by helping to support reuptake of dopamine, serotonin, nor-adrenalin and GABA. All the good things we need for a healthy and happier mood.

The interesting part of recent studies is that previously hypericin was the constituent that people thought gave the plant such a mood lifting action – however they have found it is the combination of all the constituents within the plant that lend this effect. Once again highlighting that nature is better as a whole – not an isolated constituent.St Johns wort also helps to reduce and breakdown levels of the stress hormone cortisol within the body, and it is also able to cross the blood brain barrier which can help with mood support. Clinical trials have also shown that St Johns wort helps with some of the psychological aspects due to hormonal changes like PMS, perimenopause and menopause. Using St Johns wort also helps with the reducing the side effects some find with conventional treatment, often people find they struggle with upset stomachs with some medications. This does not happen with St Johns wort.

Do I Need A Prescription

In the United States, the Food and Drug Administration considers St. Johns wort a dietary supplement and does not approve it for use as a medication.

Therefore, St. Johns wort is available over-the-counter in the U.S. and in many other countries. In some countries such as Ireland, however, a person needs a prescription to get it.

Here are a few common questions about St. Johns wort.

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Questions To Ask Your Health Team About St Johns Wort

If you are considering supplementing traditional medications with St. Johns wort, its important to consult your primary care doctor, psychiatrist, or other prescriber before doing so. Be sure to share your reasons for wanting to try the supplement. Your healthcare team will be able to determine if the plant is a viable and healthy option to pursue. Make sure to disclose any prescribed or natural medications that youre already taking to reduce the risk of adverse interactions or side effects.

Some questions to ask your provider about St. Johns wort include:

  • What should I expect when I begin a St. Johns wort regiment?
  • Are you aware of any potential adverse effects of St. Johns wort?
  • Will this supplement interact negatively with any of my other medications?

St Johns Wort And Food Reactions

St. John’s Wort for Depression: A Clinical Summary

Some people experience reactions with St. Johns wort when eating foods high in the amino acid tyramine.

Foods that have been pickled, aged, smoked, or fermented are highest in tyramine.

This includes beer and wine, many kinds of cheese, aged or cured meat, sauerkraut, fermented soy products, and chocolate.


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The combination of tyramine-rich foods and St. Johns wort is especially dangerous for anyone with high blood pressure.

Its also advised to avoid alcohol and minimize caffeine intake when supplementing with St. Johns wort.

Unless you are willing to forgo tyramine-rich foods, caffeine, and alcohol, you should steer clear of St. Johns wort supplements.

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Risks Side Effects And Interactions

Extensive research supports that St. Johns wort uses are safe when taken by mouth for up to three months, and some evidence suggests it can be used safely for over one year. St. Johns wort side effects include trouble sleeping, vivid dreams, restlessness, anxiety, irritability, stomach upset, fatigue, dry mouth, dizziness, headaches, skin rash, diarrhea and tingling.

Keep in mind that it generally takes weeks or even months for St. Johns wort benefits to become noticeable. It is not a fast-acting treatment for conditions like depression and increasing your dose isnt going to make it work immediately. You need to give it time. When taken in large doses, St. Johns wort may cause severe reactions to sun exposure, so be sure to wear sunblock outside, especially if you are light-skinned.

Taking St. Johns wort is not recommended for women who are pregnant or breastfeeding its most likely safe for children between the ages of 6 and 17, but they shouldnt take it for more than eight weeks.

There are a number of health cautions pertaining to St. Johns wort uses that need to be considered before use. Recent research shows these interactions result from the ability of St. Johns wort components to produce intestinal or hepatic enzymes that either remove drugs from the body or metabolize them to inactive forms.

Importance Of Addressing Childhood Depression

Depression is not uncommon in children and can be serious. St. John’s wort may or may not be an appropriate treatment, but you have already taken a major and important step by considering the presence of depressive symptoms in your child.

Childhood depression can be difficult to diagnose, as warning signs of depression in young children aren’t always recognized. From extreme shyness to irritability and anger, many parents assume they facing a behavioral issue rather than depression.

If you believe your child may have depression, talk to your pediatrician. They can help you learn more about using medications to treat depression in children, and how the process may be different than the approach used in adults.

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Please Help How Much Of St Johns Wort Should I Take

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Can You Take St Johns Wort With Maoi

St John

Antidepressants St. Johns wort may interact with medications used to treat depression or other mood disorders, including tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors .

Can you take vitamin D with St John Wort?

No interactions were found between st. johns wort and Vitamin D3.

How much St Johns wort should I take?

The usual dose for mild depression and mood disorders is 300 mg , 3 times per day, with meals. St. Johns wort is available in time-release capsules.

Is it safe to take St Johns Wort with other medicines?

St. Johns wort may also be used for purposes not listed in this product guide. Many drugs can interact with St. Johns wort, and serious drug interactions can occur when certain medicines are used at the same time. Do not take St. Johns wort without medical advice if you regularly use other medicines.

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What Should I Watch For While Using This Medication

If you are already being treated for anxiety, depression, or other mental state use this supplement only by your care team’s direction. This supplement my interfere with your other treatments. See your care team if your symptoms do not get better or if they get worse.

This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

If you are scheduled for any medical or dental procedure, tell your care team that you are taking this medication. You may need to stop taking this supplement before the procedure.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

Herbal or dietary supplements are not regulated like medications. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

What Is This Medication

ST. JOHN’S WORT is promoted for many conditions, such as depression, attention-deficit hyperactivity disorder , obsessive-compulsive disorder , skin conditions, and symptoms of menopause. This supplement is not intended to diagnose, treat, cure, or prevent any disease.

This medicine may be used for other purposes ask your health care provider or pharmacist if you have questions.

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What Is Samhsa’s National Helpline

SAMHSAs National Helpline, , or TTY: is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 to find help near you. Read more about the HELP4U text messaging service.

What To Look For

St Johns Wort For Anxiety, Does It Work?

St. John’s wort is widely available in pharmacies, supermarkets, and health food stores and comes in different doses. Check the Supplement Facts label for the product you choose to ensure you are getting the appropriate dose. This label also provides information about other ingredients the supplement may contain.

The National Institutes of Health suggests looking for products with a seal of approval from a third-party organization that provides quality testing, such as U.S. Pharmacopeia, Consumer Lab, or NSF International.

A seal of approval from these organizations assures a product was properly manufactured, that it actually includes the ingredients listed on the label, and does not contain harmful levels of contaminants. A seal of approval does not, however, guarantee a product’s safety or effectiveness.

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What Does St Johns Wort Do Uses And Benefits

St. Johns wort is a natural remedy often sold in tablet or capsule format or as an ingredient in a variety of wellness supplements and teas. The most common ailments St. Johns wort treats are:

  • Mild depression
  • Inflammatory diseases
  • Minor cuts and burns

As a supplement, its not regulated by the U.S. Food and Drug Administration or approved to treat any of these conditions. Though, there is some research indicating its effectiveness.

St Johns Wort: The Benefits And The Dangers

Some research shows St. Johns wort can help treat depression and other medical conditions, but experts warn there are some downsides to this herbal supplement.

St. Johns wort is natural. Its an herbal supplement that doesnt require a prescription and you can buy it at a health food store.

Sounds good, but that doesnt necessarily make it harmless, according to a study published in 2015 in the journal Clinical and Experimental Pharmacology and Physiology .

Researchers at the University of Adelaide compared adverse events of St. Johns wort and the antidepressant drug fluoxetine . The team used information from doctors reports to Australias national agency on drug safety.

Between 2000 and 2013, there were 84 adverse reaction reports for St. Johns wort. There were 447 reports for Prozac.

Since reporting adverse events is voluntary, researchers said its likely that adverse events are underreported.

Side effects of the two substances are similar.

They include vomiting, dizziness, anxiety, panic attacks, aggression, and amnesia. There are also serious concerns about drug interactions.

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Mild To Moderate Depression

Although the benefits of St. John’s wort are still being explored, research suggests the herb can be more effective than a placebo in alleviating mild to moderate depression. A 2015 review published in the Annals of Family Medicine examined whether antidepressants were more effective than a placebo for patients being treated for depression by their primary care doctor.

The researchers examined 66 previously published studies and found that both antidepressant medications and St. John’s wort extracts were more effective than a placebo for treating mild to moderate depression.

People taking St. John’s wort were also more likely to continue treatment, as the herb was associated with fewer adverse effects compared to tricyclic and tetracyclic antidepressants, selective serotonin reuptake inhibitors , a noradrenaline reuptake inhibitor , a serotonin-noradrenaline reuptake inhibitor , and noradrenergic and specific serotonergic antidepressant agents .

How Does Stjohns Wort Affect High Blood Pressure

Negative Effects of St. John

Reserpine Based on animal studies, St. Johns wort may interfere with reserpines ability to treat high blood pressure. Sedatives St. Johns wort can increase the effect of drugs that have a sedating effect, including:

What kind of interactions are there with St Johns Wort?

The Herbal Medicines Advisory Committee and the Commission on Human Medicines pharmacovigilance expert advisory group have considered the interaction between St Johns wort and antiepileptic medicines by routes other than the recognised cytochrome P450 pathway.

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