St John's wort
hypericum
“St John’s Wart”
Shredder inDucer
What it isHypericum extract containing hyperforin and hypericin; depression outside the US.
Why this oneIt has trial evidence in mild to moderate depression comparable with low-dose SSRIs.
What limits it⚑ Its CYP3A4 and P-gp induction causes contraceptive, transplant and anticoagulant failure — the interaction matters more than the effect. Serotonin syndrome with SSRIs.
FDA-approved for
- herbal for depression (non-US; not FDA-approved)
Off-label
- mild-to-moderate depression (approved as a drug in Germany)
Available strengths
- tab/cap (0.3% hypericin) 300, 450 mg
NO BOXED WARNINGS
Principal risk⚑ Its CYP3A4 and P-gp induction causes contraceptive, transplant and anticoagulant failure — the
Classes and tags
Clinical profile
Serotonin and MAOI
Provisional washout figures
Elevating mechanismSRI (preparation-dependent)
Evidence confidenceLow
InterpretationVariable, preparation-dependent serotonergic effect rather than a reliably quantifiable SRI. Avoid MAOI combinations.
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