Wondering about Wort and Grapefruit

The plant with the pretty yellow flowers was christened St. John s wort because it begins to bloom around June 24, the purported birthday of St. John the Baptist. Until a couple of years ago, Hypericum perforatum grew on our roadsides in virtual obscurity, but today preparations made from the plant jostle for our attention on the shelves of pharmacies and health food stores. Relieves insomnia, neuralgia and nervous tension, one label boldly declares, while another sedately promises to make you feel your best. Sounds intriguing. 

Today foxglove is still the source of digitoxin, a widely used drug that increases the force of the heart s contraction. To produce it chemists separate and purify one compound from the plant s roughly thirty cardiac glycosides, each of which has different activity. Manufacturers of herbal supplements do not note such distinctions they merely try to justify their products by pointing out that many of our prescription pharmaceuticals derive from plant sources. 

John s wort, like all plants, produces an array of compounds, which can account for its antianxiety and antidepressant effects. These effects are more than anecdotal they are supported by a number of studies. Most of these studies have been carried out in Germany, where doctors frequently prescribe standardized versions of the plant as an antidepressant. They actually write more prescriptions for Johanniskraut, as the plant is known in that neck of the woods, than for Prozac. In hght of a meta-analysis — a study of studies — published in 1996 in the British medical journal The Lancet, the choice of those German doctors seems justified. 

John s wort raises other concerns, as well. First of all, no one should attempt to diagnose and treat their own depression. Then there is the fact that most St. John s wort studies lasted only a few weeks, so long-term effects remain undetermined. In the short term some people may experience side effects such as upset stomach, skin rash, or tiredness, although these are less common with St. John s wort than they are with prescrip- 

A few weeks earher he had diagnosed himself with mild depression, and he d known exactly what to do about it. He d seen stories about the potential benefits of the herbal remedy St. John s wort in all kinds of tabloids and magazines, and here was his chance to give it a try. It never crossed his mind to check with his doctors first, since St. John s wort was a natural remedy, and therefore (supposedly) completely safe. But the effects of drugs on our bodies can be very complex and sometimes mysterious. While the mechanism by which St. John s wort carries out its antidepressant effect is not clear, researchers have been able to identify an unwelcome side effect. Some component in St. John s wort stimulates the production of an enzyme with the cryptic name of cyp3a, one of a number of 

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