St. John's Wort

Last Updated: September 28 2022

Hypericum Perforatum (St. John's Wort) is an anti-depressant herb that is commonly used for its neurological effects. While it appears effective, it is well known to adversely interact with a variety of pharmaceuticals.

St. John's Wort is most often used for


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; it interacts with several compounds by affecting the several phase I enzymes as well as other drug elimination pathways.

What else is St. John's Wort known as?
Note that St. John's Wort is also known as:
  • St. John's Wort
  • Hypericum Perforatum

Don't miss out on the latest research

1.^Tian J1, Zhang F1, Cheng J2, Guo S3, Liu P3, Wang H2Antidepressant-like activity of adhyperforin, a novel constituent of Hypericum perforatum LSci Rep.(2014 Jul 9)
2.^Brockmöller J1, Reum T, Bauer S, Kerb R, Hübner WD, Roots IHypericin and pseudohypericin: pharmacokinetics and effects on photosensitivity in humansPharmacopsychiatry.(1997 Sep)
3.^Kerb R1, Brockmöller J, Staffeldt B, Ploch M, Roots ISingle-dose and steady-state pharmacokinetics of hypericin and pseudohypericinAntimicrob Agents Chemother.(1996 Sep)
4.^Treiber K1, Singer A, Henke B, Müller WEHyperforin activates nonselective cation channels (NSCCs)Br J Pharmacol.(2005 May)
6.^Leuner K1, Kazanski V, Müller M, Essin K, Henke B, Gollasch M, Harteneck C, Müller WEHyperforin--a key constituent of St. John's wort specifically activates TRPC6 channelsFASEB J.(2007 Dec)
7.^Leuner K1, Li W, Amaral MD, Rudolph S, Calfa G, Schuwald AM, Harteneck C, Inoue T, Pozzo-Miller LHyperforin modulates dendritic spine morphology in hippocampal pyramidal neurons by activating Ca(2+) -permeable TRPC6 channelsHippocampus.(2013 Jan)
8.^Gobbi M1, Valle FD, Ciapparelli C, Diomede L, Morazzoni P, Verotta L, Caccia S, Cervo L, Mennini THypericum perforatum L. extract does not inhibit 5-HT transporter in rat brain cortexNaunyn Schmiedebergs Arch Pharmacol.(1999 Sep)
10.^Chatterjee SS1, Bhattacharya SK, Wonnemann M, Singer A, Müller WEHyperforin as a possible antidepressant component of hypericum extractsLife Sci.(1998)
11.^Yoshitake T1, Iizuka R, Yoshitake S, Weikop P, Müller WE, Ogren SO, Kehr JHypericum perforatum L (St John's wort) preferentially increases extracellular dopamine levels in the rat prefrontal cortexBr J Pharmacol.(2004 Jun)
12.^Russo E1, Scicchitano F, Whalley BJ, Mazzitello C, Ciriaco M, Esposito S, Patanè M, Upton R, Pugliese M, Chimirri S, Mammì M, Palleria C, De Sarro GHypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactionsPhytother Res.(2014 May)
13.^Staffeldt B1, Kerb R, Brockmöller J, Ploch M, Roots IPharmacokinetics of hypericin and pseudohypericin after oral intake of the hypericum perforatum extract LI 160 in healthy volunteersJ Geriatr Psychiatry Neurol.(1994 Oct)
14.^Biber A1, Fischer H, Römer A, Chatterjee SSOral bioavailability of hyperforin from hypericum extracts in rats and human volunteersPharmacopsychiatry.(1998 Jun)
15.^Kerb R, Brockmöller J, Staffeldt B, Ploch M, Roots ISingle-dose and steady-state pharmacokinetics of hypericin and pseudohypericin.Antimicrob Agents Chemother.(1996 Sep)
16.^Kober M, Pohl K, Efferth TMolecular mechanisms underlying St. John's wort drug interactions.Curr Drug Metab.(2008 Dec)
17.^Goodwin B, Moore LB, Stoltz CM, McKee DD, Kliewer SARegulation of the human CYP2B6 gene by the nuclear pregnane X receptor.Mol Pharmacol.(2001 Sep)
18.^Chen Y, Ferguson SS, Negishi M, Goldstein JAInduction of human CYP2C9 by rifampicin, hyperforin, and phenobarbital is mediated by the pregnane X receptor.J Pharmacol Exp Ther.(2004 Feb)
19.^Rahimi R, Abdollahi MAn update on the ability of St. John's wort to affect the metabolism of other drugs.Expert Opin Drug Metab Toxicol.(2012 Jun)
22.^Wang LS, Zhou G, Zhu B, Wu J, Wang JG, Abd El-Aty AM, Li T, Liu J, Yang TL, Wang D, Zhong XY, Zhou HHSt John's wort induces both cytochrome P450 3A4-catalyzed sulfoxidation and 2C19-dependent hydroxylation of omeprazole.Clin Pharmacol Ther.(2004 Mar)
23.^Smith P, Bullock JM, Booker BM, Haas CE, Berenson CS, Jusko WJThe influence of St. John's wort on the pharmacokinetics and protein binding of imatinib mesylate.Pharmacotherapy.(2004 Nov)
24.^Zhou S, Lim LY, Chowbay BHerbal modulation of P-glycoprotein.Drug Metab Rev.(2004 Feb)
25.^Wang Z, Gorski JC, Hamman MA, Huang SM, Lesko LJ, Hall SDThe effects of St John's wort (Hypericum perforatum) on human cytochrome P450 activity.Clin Pharmacol Ther.(2001 Oct)
27.^Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi KThe recovery time-course of CYP3A after induction by St John's wort administrationBr J Clin Pharmacol.(2008 May)
28.^Russo E, Scicchitano F, Whalley BJ, Mazzitello C, Ciriaco M, Esposito S, Patanè M, Upton R, Pugliese M, Chimirri S, Mammì M, Palleria C, De Sarro GHypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions.Phytother Res.(2014 May)
29.^Chen XW, Serag ES, Sneed KB, Liang J, Chew H, Pan SY, Zhou SFClinical herbal interactions with conventional drugs: from molecules to maladies.Curr Med Chem.(2011)
30.^Morimoto T, Kotegawa T, Tsutsumi K, Ohtani Y, Imai H, Nakano SEffect of St. John's wort on the pharmacokinetics of theophylline in healthy volunteers.J Clin Pharmacol.(2004 Jan)
31.^Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, Day RO, McLachlan AJEffect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects.Br J Clin Pharmacol.(2004 May)
34.^Tannergren C, Engman H, Knutson L, Hedeland M, Bondesson U, Lennernäs HSt John's wort decreases the bioavailability of R- and S-verapamil through induction of the first-pass metabolism.Clin Pharmacol Ther.(2004 Apr)
35.^Sugimoto K, Ohmori M, Tsuruoka S, Nishiki K, Kawaguchi A, Harada K, Arakawa M, Sakamoto K, Masada M, Miyamori I, Fujimura ADifferent effects of St John's wort on the pharmacokinetics of simvastatin and pravastatin.Clin Pharmacol Ther.(2001 Dec)
37.^Wang LS, Zhu B, Abd El-Aty AM, Zhou G, Li Z, Wu J, Chen GL, Liu J, Tang ZR, An W, Li Q, Wang D, Zhou HHThe influence of St John's Wort on CYP2C19 activity with respect to genotype.J Clin Pharmacol.(2004 Jun)
39.^Hall SD, Wang Z, Huang SM, Hamman MA, Vasavada N, Adigun AQ, Hilligoss JK, Miller M, Gorski JCThe interaction between St John's wort and an oral contraceptive.Clin Pharmacol Ther.(2003 Dec)
41.^Bauer S, Störmer E, Johne A, Krüger H, Budde K, Neumayer HH, Roots I, Mai IAlterations in cyclosporin A pharmacokinetics and metabolism during treatment with St John's wort in renal transplant patients.Br J Clin Pharmacol.(2003 Feb)
42.^Mathijssen RH, Verweij J, de Bruijn P, Loos WJ, Sparreboom AEffects of St. John's wort on irinotecan metabolism.J Natl Cancer Inst.(2002 Aug 21)
43.^Zhou S, Chan E, Pan SQ, Huang M, Lee EJPharmacokinetic interactions of drugs with St John's wort.J Psychopharmacol.(2004 Jun)
44.^Jakobs D1, Hage-Hülsmann A, Prenner L, Kolb C, Weiser D, Häberlein HDownregulation of β1 -adrenergic receptors in rat C6 glioblastoma cells by hyperforin and hyperoside from St John's wortJ Pharm Pharmacol.(2013 Jun)
48.^Müller WE1, Rolli M, Schäfer C, Hafner UEffects of hypericum extract (LI 160) in biochemical models of antidepressant activityPharmacopsychiatry.(1997 Sep)
49.^Müller WE1, Singer A, Wonnemann M, Hafner U, Rolli M, Schäfer CHyperforin represents the neurotransmitter reuptake inhibiting constituent of hypericum extractPharmacopsychiatry.(1998 Jun)
52.^Mollenhauer HH1, Morré DJ, Rowe LDAlteration of intracellular traffic by monensin; mechanism, specificity and relationship to toxicityBiochim Biophys Acta.(1990 May 7)
53.^Suzuki O, Katsumata Y, Oya M, Bladt S, Wagner HInhibition of monoamine oxidase by hypericinPlanta Med.(1984 Jun)
54.^Bladt S1, Wagner HInhibition of MAO by fractions and constituents of hypericum extractJ Geriatr Psychiatry Neurol.(1994 Oct)
55.^Thiede HM1, Walper AInhibition of MAO and COMT by hypericum extracts and hypericinJ Geriatr Psychiatry Neurol.(1994 Oct)
56.^Linde K, Berner MM, Kriston LSt John's wort for major depressionCochrane Database Syst Rev.(2008 Oct 8)
57.^Linde K, Berner M, Egger M, Mulrow CSt John's wort for depression: meta-analysis of randomised controlled trialsBr J Psychiatry.(2005 Feb)
58.^Gelenberg AJ, Shelton RC, Crits-Christoph P, Keller MB, Dunner DL, Hirschfeld RM, Thase ME, Russell JM, Lydiard RB, Gallop RJ, Todd L, Hellerstein DJ, Goodnick PJ, Keitner GI, Stahl SM, Halbreich U, Hopkins HSThe effectiveness of St. John's Wort in major depressive disorder: a naturalistic phase 2 follow-up in which nonresponders were provided alternate medicationJ Clin Psychiatry.(2004 Aug)
59.^Brenner R, Madhusoodanan S, Pawlowska MEfficacy of continuation treatment with hypericum perforatum in depressionJ Clin Psychiatry.(2002 May)
60.^Fava M, Alpert J, Nierenberg AA, Mischoulon D, Otto MW, Zajecka J, Murck H, Rosenbaum JFA Double-blind, randomized trial of St John's wort, fluoxetine, and placebo in major depressive disorderJ Clin Psychopharmacol.(2005 Oct)
64.^Laakmann G, Schüle C, Baghai T, Kieser MSt. John's wort in mild to moderate depression: the relevance of hyperforin for the clinical efficacyPharmacopsychiatry.(1998 Jun)
67.^Hänsgen KD, Vesper J, Ploch MMulticenter double-blind study examining the antidepressant effectiveness of the hypericum extract LI 160J Geriatr Psychiatry Neurol.(1994 Oct)
72.^Behnke K, Jensen GS, Graubaum HJ, Gruenwald JHypericum perforatum versus fluoxetine in the treatment of mild to moderate depressionAdv Ther.(2002 Jan-Feb)
79.^Harrer G, Schmidt U, Kuhn U, Biller AComparison of equivalence between the St. John's wort extract LoHyp-57 and fluoxetineArzneimittelforschung.(1999 Apr)
80.^Vitiello B, Shader RI, Parker CB, Ritz L, Harlan W, Greenblatt DJ, Gadde KM, Krishnan KR, Davidson JRHyperforin plasma level as a marker of treatment adherence in the National Institutes of Health Hypericum Depression TrialJ Clin Psychopharmacol.(2005 Jun)