The St. John's wort plant has yellow flowers and is a weed in some parts of the U.S. Although it is best known today for its use by patients with mild to moderately severe depression, St. John's wort has also been used orally as a traditional treatment for excitability, neuralgia, fibrositis, sciatica, and anxiety and as a topical preparation for the treatment of wounds (1). Rosenthal says several dozen of the mildly depressed patients he's treated have used St. John's Wort with good results. That herbal medicines may have adverse pharmacologic properties has come as a surprise to those who assumed that natural products must be safe. Extracts of it have been used for centuries to treat depression, including, reportedly, by the roman emperor Nero. Don't self-medicate. Some studies show that it can be just as effective as prescription medication. (15) in this issue of the Journal. Herbal and homeopathic forms of St. John's Wort have different indications and different guidelines for their usage. Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John's wort. And as many as two million are believed to be treating themselves with this. Common St. John's wort was so valued for its medicinal qualities in its native Europe that settlers brought it over with them to the New World. Drug interaction between St John's wort and nevirapine. The oil is applied externally to relieve the pain of neuralgia and promote the healing of burns, bruises, and hemorrhoids, and is taken internally for intestinal disorders. Hypericin also causes catalytic inhibition of human DNA topoisomerase II α in cell cultures (8). The report by Mathijssen et al. Thank you. Introduction: St John's wort is a popular herbal remedy recommended by Traditional Chinese Medicine (TCM) practitioners and licensed and widely prescribed for depression in many European countries. With increased availability in the American marketplace and increased public consumption of herbal medicines over the past decade, however, the specter of herb–drug interactions has emerged as a credible public health problem. According to a recent systematic review (2), four of the seven top-selling herbal medicines in this country interfere with the metabolism or efficacy of approved synthetic drugs: Ginkgo biloba (ginkgo) may enhance or alter the effects of warfarin, thiazide diuretics, and trazodone. Surveys have shown that cancer patients are among the most likely to seek complementary and alternative medical (CAM) remedies, including herbal medicines, with the hope that they would reduce the side effects of conventional treatments, extend life, or at least enhance quality of life (16). de Maat MM, Hoetelmans RM, Math t RA, van Gorp EC, Meenhorst PL, Mulder JW, et al. What to expect in Georgia’s special election for two key Senate seats, Read If you have those features, don't mess around. Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. Read Please check your inbox to confirm. Durr D, Stieger B, Kullak-Ublick GA, Rentsch KM, Steinert HC, Meier PJ, et al. Hereâs how it feels when COVID-19 symptoms last for months, Read Learn more about Friends of the NewsHour. St. John's Wort has always been in the news as an herbal remedy for solving mild forms of depression. Another difference is that homeopathic Hypericum comes in very diluted form and is FDA approved and regulated. So someone would come in and say, "I've taken the herb and it really didn't help me at all.". Rosenthal says that research loophole could be plugged later this year. St. John's wort induces highly promiscuous drug detoxification pathways and thus interferes with metabolism of many classes of drugs. In fact, an undesirable interaction between St. John's wort and cancer drugs has now been realized in the report by Mathijssen et al. Ornamental Use. Concerns over its use have been raised with the recognition that, whatever its beneficial health effects might be, St. John's wort interacts powerfully with many important drugs, potentially mitigating their effects (1). I saw enough people, it started giving me some concern that perhaps something was wrong here and that St. John's Wort was not going to be effective for the treatment of depression. 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