St John's Wort

St. John's Wort ('hypericum perforatum') is a commonly grown herb, growing wild in many countries and producing small yellow flowers. It seems to have been named after John the Baptist; it is most abundant around the time of his birthday on the 24th June. Traditionally gathered at his feast, some believed that if placed under their pillow on St John's Eve, they would be blessed and evil spirits would be chased away. 'Wort' is the old English name for 'plant'

WHAT IS IT USED FOR?
St. John's Wort has been used since the first century for conditions such as depression, mania, anxiety, fatigue and insomnia as well as for inflammation and wound healing. The ancient Greeks used it as a 'nerve tonic'

• In Germany it has been licensed for use in depression, anxiety and sleep disorders since 1984. There it is widely prescribed for mild to moderate depression
• In the United States it is sold as a nutritional supplement and recommended for depression, anxiety, insomnia and inflammation
• In the United Kingdom it is available in health shops and recommended for depression, anxiety and insomnia as well as for menopausal symptoms
  

HOW DOES IT WORK?
This is unclear. It contains at least 10 different chemicals. Many are active and affect the body in some way. To produce its antidepressant effect, it seems to affect the levels of brain chemicals especially those called serotonin and noradrenaline. It is recommended to take St John's Wort for 10-14 days to have an effect, and to take it for a month before experiencing the full benefit. After about six weeks it may be possible to reduce the dose gradually without a decline in mood, returning to the full dose if symptoms worsen. Alternatively you may prefer to stop after eight weeks, resuming treatment if your symptoms return

IS IT BETTER THAN TRADITIONAL ANTIDEPRESSANTS?
Research has shown that many people have found it useful for symptoms of mild to moderate depression. But the quality of the research may not be good. More research is needed to decide whether it is more effective than traditional antidepressants. It is not as effective as antidepressants in severe depression. Not enough research has been done on its long-term use

SIDE EFFECTS
About 1 in 4 people may experience mild to moderate side effects which disappear when St John's Wort is stopped. The following side effects have been reported:

• Stomach upsets and dry mouth
• Allergic reaction
• Tiredness, dizziness and confusion
• Irritability and restlessness
• Redness of skin after short exposure to the sun
  

If you are concerned about side effects consult your local pharmacist

WHEN NOT TO TAKE ST JOHN'S WORT
St John's Wort should not be taken if you are pregnant or breast feeding, and it should not be given to babies or children

INTERACTIONS
St John's Wort interacts with other medication causing the level of the other medication to increase or decrease within the body. This may reduce the effectiveness of the medication or may produce serious side effects. The use of St John's Wort should be avoided if you are taking any of the following:

• Antidepressants
• Oral Contraceptive Pill
• Medication for epilepsy and migraines
• Warfarin, digoxin, theophyline and cyclosporin
  

If you are taking St John's Wort along with other medication, speak to your doctor or pharmacist to discuss whether you should stop St John's Wort. If you have to stop it, you may have to reduce it gradually

IF YOU ARE THINKING ABOUT TAKING ST JOHN'S WORT

• If you are taking other medication, speak to your doctor or pharmacist before starting St John's Wort
• Do not start St John's Wort whilst on a standard antidepressant. Consult your doctor
• If you think you are depressed, consult your doctor before starting St John's Wort since it is important to make the right diagnosis, rule out any other illness and ensure you get the most appropriate treatment
  

HELP AND SUPPORT

• Leeds Counselling, 0113 245 0303 www.leedscounselling.org.uk
• Leeds Mind Counselling and Therapy Service 0113 230 7673 www.leedsmind.org.uk
  
• Depression Alliance, 35 Westminster Bridge Rd, London SE1 7JB, Helpline 0207 6330557 www.depressionalliance.org
  

Self help books:

• Managing Anxiety & Depression, Mental health Foundation www.mentalhealth.org.uk
  
• Overcoming Depression and low mood, 2nd edition 2006, Dr Chris Williams, (Hodder Arnold H & S)
  
• Mind over Mood: Cognitive Treatment Therapy Manual for Clients, Christine Padesky & Dennis, Greenberger (Guildford Press)

There are hundreds of organisations working in Leeds. These are just a few which may be able to help you find the right one:

• www.mentalhealthleeds.info (Leeds Mental Health Directory on-line) Includes database of more than 600 organisations working on mental health in Leeds, and direct links to many other useful websites
• Samaritans - 08457 909 090. Free phone line offering emotional & confidential support for people who are experiencing feelings of distress or despair, including those which may lead to suicide (24 hours)
• NHS Choices - 0845 46 47 (24 hours). Free information service on all aspects of health problems, NHS services and other local services www.nhs.uk
• MIND Infoline - 08457 660 163. Free national information line (9.15am-5.15pm, Monday-Friday) - interpretation available for over 100 languages www.mind.org.uk
• Mental Health Foundation: www.mentalhealth.org.uk
• www.besttreatments.co.uk (provides clinical evidence for patients on a range of problem areas)

Source text: Leeds Mental Health Trust and Leeds Primary Care Trusts
Image source: Shooting Star Native Seeds
The original version of this leaflet was written by Ardsley Community Mental Health Team, East Ardsley Health Centre, Wakefield WF3 2DN

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Last revision: January 2012