Q and A: Treat Severe Depression with St. John's Wort

Image Gallery St. John's Wort is often used as a treatment for depression, but must be taken continuously.

In every issue of Herbs for Health, professionals from a variety of health-care fields ­answer your questions about using medicinal herbs. Medical doctor Robert Rountree and herbalist Daniel Gagnon responded for this issue.  

Q&A

I am a twenty-four-year-old female, and I suffer from depression and a lot of stress. Although my depression is not constant, it tends to be very severe. After reading the article “Depression: Herbs that Help” (November/December 1996) I began taking St.-John’s-wort extract. I take two 300-mg capsules daily, and I plan to take them for three weeks and then take a break. Do you think this is a good routine, and is there anything more I should know about this herb?
N. D.
Hamilton Square,
New Jersey

The recommended dose of St.-John’s-wort (Hypericum perforatum) for serious depression is 900 mg daily, using a preparation standardized to contain 0.3 percent hypericin. Since it may take two to three weeks before you experience consistent improvements in mood, there would be no advantage in taking a break from therapy. In fact, the longer you take it, the more likely it is to be beneficial.

Its mechanism of action is unclear, although some researchers believe that it has similarities to a class of anti-depressant drugs called mono­amine oxidase inhib­itors. For this reason, there is a theoretical risk (but no published reports) of interactions with prescription ­antidepressants and foods containing vasoactive amines such as wine, chocolate, ­fermented cheeses, and ­bananas.

The most significant side effect of St.-John’s-wort is increased sun sensitivity. If you do take therapeutic doses of hypericum and must spend time in the sun, be certain to use adequate skin protection.
—Robert Rountree