St. John's Wort 
  (Hypericum perforatum)

General Description:  A shrubby perennial plant with yellow flowers, native to Europe but now grows in many parts of the world. 

Parts Used:  Flower

Uses: 

 mild to moderate depression (not major)

 2nd & 3rd degree burns

  AIDS (inhibiting the spread)

 anti-viral against herpes 1& 2

 antibacterial against gram positive and negative

 pain associated with arthritis and sciatica

 mood swings

 insomnia

 MS, fibromyalgia and neuromuscular inflammations

Action:  Active ingredient is hypericin.  Acts as a SSRI, keeps serotonin active in the brain.  Suppresses interleukin 6, releasing affecting mood through neurohormonal pathways.  Also produces, antiviral, anti-inflammatory anti-microbial and astringent properties.

Dosage:  300mg 3 times/day with meals, no more than 8 weeks.

     Tincture:  1:2, 2-4 mls 3 times/day  For wounds:  use a tincture and cover with gauze or bandage.

Precautions/Adverse Effects:  Photoxicity,  headache, nervousness, fatigue, restlessness, mania  and SSRI syndrome

Interactions with other Drugs:  Antidepressants (SSRIs, tricyclics, MAOI's), Caffeine, Theophylline, concurrent use of antibiotics, Dopamine agonists, OTC cough and cold remedies, sleep aids, AIDS medicine - Indinavir by decreasing the  effectiveness.  

          Interactions with other herbs:  yohimbe, feverfew, ma haung, ginseng. 

Contraindications:  Fair skin with sun exposure, severe depression, mania, seizures, migraines, and Pregnancy/Lactation/Children.

Nursing Considerations:  

      Individuals should consult a health care provider to be evaluated for 
          depression. 

        Wear sunscreen due to phototoxicity.

        Do not use OTC medications with alcohol  and St. John's Wort.

        Do not use prior to surgery. 

        Current Research:  In 1998, the National Institutes of Health began a 3-year study to investigate the efficacy of St. John's wort for the treatment of major depressive disorders.  This study compares the extract of St. John's wort with a SSRI and placebo.  In 1999, another study was started.  This study is currently  recruiting patients.  It is entitled "Drug Interaction Study of Tegretol (Carbamazepine) and St John's Wort in Normal Volunteers".