St. John’s wort Hypericum

St. John s wort Hypericum Antidepressant and Usually mild. May May decrease efficacy of... 

A. Johne, J. Brockmoller, S. Bauer, A. Maurer, M. Langheinrich, and I. Root, Pharmacokinetic interaction of digoxin with an herbal extract from St. John s wort (Hypericum perforatum). Clin. Pharmacol. Ther., 66, 338-345 (1999). 

In addition to this serious diet-drug interaction, irreversible MAOIs also potentiate the effects of sympathomimetic drugs like ephedrine found in over-the-counter cold remedies and recreational stimulants like amphetamine. The MAOIs also interact with drugs that increase synaptic concentrations of 5-HT, such as the tricyclic antidepressant clomipramine and the herbal SSRI antidepressant St John s wort (Hypericum spp.). The resulting serotonin syndrome is characterised by hyperthermia and muscle rigidity. While devoid of these side effects the reversible MAO-A inhibitor moclobemide has yet to establish itself as a first-line alternative to the SSRIs. 

Dimpfel W, Schober F, Mannel M. (1998). Effects of a methanolic extract and a hyperforin-enriched C02 extract of St. John s Wort (Hypericum perforatum) on intracerebral field potentials in the freely moving rat (Tele-Stereo-EEG). Pharmacopsychiatry. 31(suppl 1) 30-5. 

Ernst E, Rand JI, Barnes J, Stevinson C. (1998). Adverse effects profile of the herbal antidepressant St. John s wort (Hypericum perforatum L.). EurJ Clin Pharmacol. 54(8) 589-94. 

Herbal antidepressants - St John s Wort (Hypericum officinalis)... 

St. John s wort (Hypericum perforatum) Relieves anxiety and depression prevents insomnia relieves some skin disorders... 

St John s Wort (Hypericum perforatum, S JW) has been on the herbal pharmacopeia for many years. It is a traditional remedy for depression which has been validated in recent randomized clinical trials. Like many herbal preparations levels of active constituents vary from one preparation to another. As a consequence of its validation as an active preparation it has been widely promoted. Recently it has been shown to interact with a variety of other substances probably through the process of drug interaction. 

Table 9. The effect of St John s wort Hypericum perforatum) on some conventional drugs ...

Markowitz, J.S., DeVane, C.L., Boulton, D.W, Carson, S.W, Nahas, Z., and Risch, S.C. (2000) Effect of St. John s wort (Hypericum perforatum) on cytochrome P-450 2D6 and 3A4 activity in healthy volunteers. Life Sci 66 PL133-PL139. 

Nathan P. The experimental and clinical pharmacology of St. John s wort (hypericum perforatum L). Mol Psychiatry 1999 4 333-338. 

Wang Z, Gorski JC, Hamman MA, Huang SM, Lesko LJ, Hall SD. The effects of St. John s wort (Hypericum perforatum) on human cytochrome P450 activity. Clin Pharmacol Ther 2001 70 317-326. 

Barnes J, Anderson LA, Phillipson JD. St John s wort Hypericum perforatum L.) a review of its chemistry, pharmacology and clinical properties. J Pharm Pharmacol 2001 53 583-600. 

St. John s wort (Hypericum perforatum) is a perennial wildflower indigenous to Europe, North Africa, and western Asia (Fig. 1) and has been used for medicinal purposes for over two millennia. As far back as the early 16th century, St. John s wort was used primarily to treat anxiety, depression, and sleep disorders. In the late 20th and early 21st century, St. John s wort has been recommended for the treatment of mild to moderate depression (7). In support of its use for the treatment of mild to moderate depression, a number of clinical trials have demonstrated that St. John s wort has comparable efficacy to the tricyclic antidepressants (i.e., imipramine) and selective serotonin reuptake inhibitors (e.g., fluoxetine and paroxetine) (8-13). 

Breidenbach T, Kliem V, Burg M, Radermacher J, Hoffmann MW, Klempnauer J. Profound drop of cyclosporin A whole blood trough levels caused by St. John s wort (Hypericum perforatum). Transplantation 2000 69(10) 2229-2230. 

Hebert MF, Park JM, Chen YL, Akhtar S, Larson AM. Effects of St. John s Wort (Hypericum perforatum) on tacrolimus pharmacokinetics in healthy volunteers. J Clin Pharmacol 2004 44(l) 89-94. 

Izzo AA. Drug interactions with St. John s Wort (Hypericum perforatum) a review of the clinical evidence. Int J Clin Pharmacol Ther 2004 42(3) 139-148. 

St. John s Wort Hypericum perforatum L.) A Review. Christopher Hobbs-Health World Online, 1996. 

---