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St. John's Wort (Hypericum Perforatum) is a herb which, through the active component Hypericin, works as a dopamine-related anti-depressant and is effective at doing so. This is also the prototypical 'adverse drug-interaction' herb
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St. John's Wort
St. John's Wort is a relevant CYP3A4 inhibitor, and should not be used with pharmaceuticals that are metabolized by this enzyme. If using any of these pharmaceuticals, consult a medical professional before supplementation of St. John's Wort with other CYP3A4 inhibitors (like Berberine)Examine.com Medical Disclaimer
The plant Hypericum perforatum, commonly referred to as 'St. John's Wort',
A 2008 Cochrane Meta-Analysis of 29 trials (5489 patients) that were blinded and randomized in patients with major depression (DSM-IV criteria) noted that in the trials against placebo that St. John's Wort was associated with less depressive symptoms with an Odds Ratio of 1.28 (95% CI of 1.10-1.49) in larger trials and 1.87 (95% CI of 1.22 to 2.87) in the smaller trials. The studies in this meta-analysis were quite heterogeneous, lasting between 4-12 weeks but was comprised of high quality studies (assessed by Jadad; 5/5 median value); this meta-analysis restricted studies to those in Major Depression, rather than the previous Meta-Analysis looking at all depressive studies.
When St. John's Wort was compared to Tricyclic Antidepressants (TCAs) and SSRIs, the respective Odds ratio benefitting St. John's Wort were 1.02 and 1.00 respectively; suggesting that the was no practical difference between the pharmaceuticals and St. John's Wort. Additionally, dropouts associated with St. Johns wort were significantly less than both TCAs (OR of 0.24) and SSRIs (OR of 0.53) suggesting that St. John's wort has less side-effects.
The studies included in this meta-analysis that were against placebo are cited here, with those comparative in nature (against pharmaceuticals) cited here against SSRIs or TCAs.]
Non-response to St. John's Wort has been noted in some persons.
St. John's Wort, overall, appears to reduce depressive symptoms with a potency not significantly different than SSRIs and TCAs (Pharmaceutical anti-depressants); some non-responders to St. John's Wort have been noted, who then respond to regular therapy
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