Depression and mood-related disorders can bring down the quality of life. Mental conditions are also known to impact your physical wellbeing as well as productivity levels. Timely treatment of mental disorders can help avoid other serious clinical conditions such as diabetes, arthritis, cardiac dysfunction, etc. As part of treatment plan, antidepressant drugs are widely prescribed. Most of these drugs work to restore the right balance of brain chemicals such as serotonin. There are also a few herbal medicines which are known to bring relief from depressive conditions. One such herbal drug is St. John’s wort; this is used for treating signs associated with depression. But, it may also cause a few undesired side effects.
Mental health plays an important role in influencing your thoughts and actions. But, being sad once in a while is a normal thing. It turns into a mental condition only if sadness or anxieties persist for a longer timeframe. The typical signs of depression include lack of interest in your hobbies or being in continuous spells of sadness. In many people, the signs of depression may also show up as a drop in appetite levels, sleep-related disorders as well as problems with staying focused. In extreme cases of depression, you may nurse self-harming thoughts or suicide.
St. John’s wort an herbal Antidepressant
Drugs widely administered for the treatment of several mental conditions are categorized as antidepressants. Most of these drugs work to restore a balance of neuro-transmitting chemicals. There are also a few naturally available herbs which can help manage depressive mental conditions. One such herb is St. John’s wort. This herb is named so because its first blossoms appear during St. John’s birthday. “Wort” means a “plant” in vintage English. This plant can be easily identified by its yellow colored, bright flowers. However, this herb also has a few other names – namely, goat weed, hypericum (a botanical name), weed of Tipton, etc. In some regions, it is also called as a weed of Klamath.
Uses of the herb
This herb is in use over many centuries mainly for its medicinal properties. It has been in varied applications; it is known to boost renal health, lung conditions, elevate moods as well as mental wellbeing and also can manage sleeping difficulties. In modern times, its use is largely restricted as a natural means to bring down depression levels, hyperactive attention deficit behavior (ADHD) and for post-menopausal anxieties. Topical application of this drug is known to treat a few skin-related conditions such as bruises and wounds.
This herb’s popularity has been increasing owing to its unique therapeutic properties. Though the outcomes of its use are linked to easing of depression or anxieties, its mechanism of action is not fully researched or documented. It is widely believed that the herb can increase the serotonin levels. When you are depressed, levels of serotonin are at a low; so, this herb helps build-up the level and thus help minimize effects of depression. However, this herb can also trigger a few side effects and some adverse reactions.
Side effects of St. John’s wort
This herb is available as an orally-consumed supplement as well as a topical cream. Its use is restricted for a shorter span of time. Intake of oral supplements of St. John’s wort can cause a few side effects such as headaches, feeling drowsy, being agitated or restless, dryness of mouth, drop in libido, etc. A few people have experienced a tingling sensation, fear psychosis and a likely damage of hepatic wellbeing. You are advised to know about the common signs of impairment of liver condition – these may include discoloration of skin or eyes, changes in appetite levels, etc.
Similar to oral intake, topical application of this herb can also trigger a few side effects. Formation of hives or rashes is common when applied onto your skin. You may also develop extra-sensitivity to sunlight. Your skin may redden and may itch when exposed to direct sunlight. It has been observed that oral intake of this herb may also cause photosensitivity. Owing to this, if your medical history includes lupus, your treating doctor needs to be informed about such conditions. Also, a few drugs may increase your sensitivity levels to light; it is advised to talk to your pharmacist to avoid likely co-administration of these drugs with supplements derived from St. John’s wort.
Pregnancy and breastfeeding
It is not clearly known if this herb can cause harm your fetus while you are pregnant. It is hence a safe practice to consult your treating doctor about the possible risks of taking or applying drugs made from St. John’s wort. Also, it is a good practice to proactively inform your doctor if you are planning to become pregnant, if you are using birth control pills or any other means to control birth.
The herb’s effects on mother’s milk are also not fully documented. Risks of the active ingredients of this drug getting into breastmilk remain largely unknown. So, if you are nursing a baby, it is highly recommended to stay away drugs whose effects need more medical research and clinical study.
Other clinical conditions
This herb is likely to aggravate a few pre-existing medical problems; especially, mental health conditions. It is important to tell your physician about prior mental conditions. For added safety, you may also need to disclose critical information about your family’s health history. In general, if such histories include conditions such as extreme spells of depression, schizophrenia, bipolar disorders, Alzheimer’s, attention deficit hyperactivity disorders, attempts to commit suicide, etc., your doctor needs to be made aware of them.
Likely interactions with other drugs
This herbal supplement is known to work adversely when taken with a few drugs. It is a good practice to tell your doctor about all the other medications you are presently taking. You may also need to share information on treatment plans currently pursued. As an added safety measure, make a list of all the drugs you are taking; while making this list, take care to include over the counter (OTC) meds, prescription drugs, other herbal supplements or dietary aids, vitamins, etc.
On the whole, herbal meds like those derived from St. John’s wort are known to cause lesser side effects than antidepressants like selective serotonin reuptake inhibiting drugs, serotonin norepinephrine reuptake inhibitors or antidepressants of the tricyclic genre. But, if your medication plan includes consumption of any other forms of antidepressants, your doctor needs to know of it. Intake of antidepressant-drugs along with St. John’s wort can increase serotonin levels to a new high. This may lead to toxicity or syndromes of excessive neuro-transmitters. The typical signs of high level of serotonin are sweating, tremors, abdominal discomforts like nausea, being in a confused state of mind as well as a likely loss of motor function. If you witness any of these signs, you are advised to seek medical help or call a poison control unit as quickly as possible.
Apart from antidepressants, you may need to be cautious while taking a few forms of antibiotics, blood thinning drugs, birth control pills (especially, those taken orally) as well as immunosuppressant meds which taken to avoid organ rejection risks associated with transplant procedures. Also, it is a good practice to tell your doctor prior to taking anxiety-reducing drugs or those which bring about sedative effects. Most of the drugs taken to treat common cold, cough or fever may also possess sedative properties; you need to exert needful caution while using such drugs along with supplements of St. John’s wort.
Surgical procedures and use of this herb
It is essential to tell your surgical team about the use of supplements based on St. John’s wort, prior to surgical or dental interventions. As this herb may interact adversely with anesthetic drugs, this precaution is very important. In most cases, your surgeon may advise discontinuing the use of this herbal drug at least for 15 – 21 days prior to the date of surgery or dental procedure. In case of procedures like transplant of organs such as kidneys, your system may try to reject the newly transplanted organ. In such instances, your surgical team may prescribe suppressants to minimize such rejection risks. Drugs derived from St. John’s wort are known to reduce the efficacy of such suppressants. Your transplant surgeon may tell you to completely stop using all products based on this herb to ensure added safety.
Safe usage of St. John’s wort
Clinical studies done to establish a safe dosage level of this herb are yet to arrive at a full-fledged recommendation. However, a few studies indicate that a safe dosage level can be around 1000 milligrams (mg) in a span of 24 hours. In some cases, a dosage of 320 mg has been prescribed thrice per day; thus, the daily dose is kept under 1000 mg per day. Always ensue that the maximum dosage must however not exceed beyond 1,500 mg in a span of 24-hours.
Dosage levels of St. John’s wort can depend on multiple factors; these include your gender (sex), age, presence of other clinical conditions and how well your body reacts to the initial doses of this herbal supplement. In most cases, no two people may need the same level of dosages of this herb. Hence, it is very important to share all needful information to help your medical team to prescribe a safer medication plan that suits you best.
The dosage level of St. John’s wort may also depend on the form in which it is used. This herb is available as oil, liquid formulation as well as in a dried form. You need to know efficacy levels of each of these forms vary from one another. In general for treating depressive conditions or anxieties, an oral supplement is widely regarded as more effective than a topical variant.
Storage of supplements made from St. John’s wort
The place where you store this drug has a direct bearing on its efficacy. This herbal drug is extremely sensitive to light sources. This is why its packs are made in dark shades and the pack is tightly sealed for added safety. You are advised to store this herbal drug in a dark, dry and cool area. It is important to keep this drug away from the reach of pets and children. Some of the herbal products may not observe child-proofing as a priority while packing; hence, an added precaution is needed on this aspect.
In sum, oral intake of St. John’s wort-based supplements may trigger a few side effects such as restlessness, dehydration, erectile dysfunction, headache, drowsiness or dizziness, agitation, etc. In some users, a likely damage of hepatic wellbeing has also shown up. Upon sensing any of these adverse side effects, you are advised to stop taking this herbal supplement and take needful medical help immediately.