In St. John’s wort flowers (Hypericum perforatum), the biologically active ingredients hypericin, hyperforin and contain. St. John’s wort may possibly increase the concentration of serotonin in the CNS and in very high doses as an MAO (monoamine oxidase) inhibitors act.

(See also nutritional supplements Overview.) In St. John’s wort flowers (Hypericum perforatum), the biologically active ingredients hypericin and hyperforin are included. St. John’s wort may possibly increase the concentration of serotonin in the CNS and in very high doses as an MAO (monoamine oxidase) inhibitors act. Claims The study results are different, but St. John’s wort could help patients with mild to moderate depression who do not have suicidal thoughts. Well-constructed studies have been conducted on St. John’s wort to treat severe depression. Dosages are 300-900 mg once daily p.o. (Sodium for a standardized preparation 0.2- 0.3% sodium hypericin or 1-4% hyperforin or both). St. John’s wort should even with HIV infection have a therapeutic benefit because Hypercirin a variety of encapsulated viruses, inclusive HIV inhibits; However, there has been proven to strong interactions with protease inhibitors and non-nucleoside reverse transcriptase inhibitors (NNRTIs) and should therefore be avoided (1-2). It was also claimed that with St. John’s wort skin diseases can be treated, including psoriasis and attention deficit / hyperactivity disorder (ADHD) in children. Numerous documents randomized, placebo-controlled studies have demonstrated the safety and efficacy of SJW in the treatment of mild to moderate depression and recently with major depressive disorder rated (3-8). St. John’s Wort was also with tricyclic antidepressants (amitryptilline, imipramine) and more recently with the SSRIs fluoxetine and sertraline compared (4-7). Most placebo-controlled trials have demonstrated that standardized extracts of SJW in the dose range of 300 mg to 900 mg once daily moderately effective in treating mild to moderate depressive symptoms. Some studies have shown the equivalence of 900 mg St. John’s wort to low-dose imipramine and low-dose fluoxetine. A study of patients with severe depression has neither compared to placebo shown over a short period no significant improvement even compared with standard doses of sertraline (7). However, the authors state that both St. John’s wort and sertraline have been effective over long periods equal, indicating the potential as alternative economic value of St. John’s wort as a therapeutic agent for the treatment of depression, when taken in low doses and when drug interactions not are relevant (7). Overall, some studies show the effectiveness of St. John’s wort in the treatment of mild depression, while for large depression, most studies do not demonstrate efficacy. The differences in the design of the studies (lack of active control and placebo), the study populations (large vs light / medium depression), duration and dose of St. John’s wort or comparison means are probably responsible for some discrepancies in the results. Two very small pilot studies show possible alleviation of skin disorders by topical application, including psoriasis (9-10). A small study showed that St. John’s wort (standardized hypericin, but not hyperforin) the symptoms of ADHD in children can not alleviate (11). Possible side effects include sensitivity to light, dry mouth, constipation, drowsiness, confusion and manias (in patients with bipolar disorder). During pregnancy, St. John’s wort is contraindicated. Drug interactions as undesired side effect may interact with cyclosporine, digoxin, iron preparations, MAO inhibitors, NNRTI, oral contraceptives, protease inhibitors, SSRIs, tricyclic antidepressants and warfarin occur (12-14). Notes on St. John Maury W, Price JP, Brindley MA, et al. Identification of light-independent inhibition of human immunodeficiency virus-1 infection through bioguided fractionation of Hypericum perforatum. Virol J6: 101-113, 2009. Kakuda TN, Schoeller Gyüre M, Hoetelmans RM. Pharmacokinetic interactions between etravirine and non-antiretroviral drugs. Clin Pharmacokinet 50 (1): 25-39, 2011. Solomon D, Adams J, Graves N. Economic evaluation of St. John’s wort (Hypericum perforatum) for the treatment of mild to moderate depression. J Affect Disord 148 (2-3): 228-234, 2013. van Gurp G, Meterissian GB, Haiek LN, et al. St John’s wort or sertraline? Randomized controlled trial in primary care. Can Fam Physician 48: 905-912, 2002. Woelk H. Comparison of St John’s wort and imipramine for Treating depression: randomized controlled trial. BMJ 321 (7260): 536-539, 2000. Fava M, Alpert J, Nierenberg AA, et al. A double-blind, randomized trial of St John’s wort, fluoxetine, and placebo in major depressive disorder. J Clin Psychopharmacol 25 (5): 441-447, 2005. Sarris J, Fava M, Schweitzer I, et al. St John’s wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT. Pharmacopsychiatry 45 (7): 275-278, 2012. Shelton RC, Keller MB, Gelenberg A, et al. Effectiveness of St John’s wort in major depression: a randomized controlled trial. JAMA 285 (15): 1978-86, 2001. Najafizadeh P, Hashemian F, Mansouri P, et al. The evaluation of the clinical effect of topical St Johns wort (Hypericum perforatum L.) in plaque-type psoriasis vulgaris: a pilot study. Australas J Dermatol 53 (2): 131-135, 2012. Rook AH, Wood GS, Duvic M, et al. A phase II placebo-controlled study of photodynamic therapy with topical hypericin and visible light irradiation in the treatment of cutaneous T-cell lymphoma and psoriasis. J Am Acad Dermatol 63 (6): 984-990, 2010. Weber W, Vander Stoep A, McCarty RL, et al.Hypericum perforatum (St John’s wort) for attention-deficit / hyperactivity disorder in children and adolescents: a randomized controlled trial. JAMA299 (22): 633-2641, 2008. Borrelli F, Izzo AA. Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations. AAPS J11 (4): 710-727, 2009. Nadkarni A, Oldham MA, Howard M, et al. Drug-drug interactions between warfarin and psycho tropics: updated review of the literature. Pharmacotherapy 32 (10): 932-942. 2012. Tsai HH, Lin HW, Simon Pickard A, et al. Evaluation of Documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract 66 (11): 1056-1078, 2012 found.

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