Research

St. John's Wort

162 peer-reviewed studies curated from PubMed and Semantic Scholar.

20
Meta-analyses
26
Systematic reviews
61
RCTs
55
Other studies
Meta-analyses (12%)
Systematic reviews (16%)
RCTs (38%)
Observational (3%)

Studies

Sorted by quality and recency

2025·Neuropsychopharmacology reports·Minoru Urata, Hitoshi Sakurai, Fumihiko Ueno, et al

Efficacy of Pharmacological Interventions in Milder Depression: A Systematic Review and Meta-Analysis.

Meta-analysisn = 1,049Mood

This systematic review and meta-analysis assessed the efficacy of pharmacological interventions, including supplements, for mild depression. St. John's Wort was compared to fluoxetine in two trials, showing no significant difference in response or dropout rates. Eicosapentaenoic acid and Rhodiola rosea showed significant improvements in depressive symptoms compared to placebo, while magnesium chloride was effective in non-blinded trials.

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2023·Advances in clinical and experimental medicine : official organ Wroclaw Medical University·Xin Zhao, Hong Zhang, Yanyan Wu, et al

The efficacy and safety of St. John's wort extract in depression therapy compared to SSRIs in adults: A meta-analysis of randomized clinical trials.

Meta-analysisn = 2,270Mood

Meta-analysis of 14 clinical trials with 2270 depression patients comparing St. John's Wort to SSRIs and placebo. St. John's Wort reduced depressive symptoms and HAMD scores with fewer risks and side effects than SSRIs.

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2023·Journal of psychiatric research·Catarina Rodrigues Cordeiro, Beatriz Romão Côrte-Real, Rodrigo Saraiva, et al

Triggers for acute mood episodes in bipolar disorder: A systematic review.

Systematic reviewMood

Systematic review identifying triggers of acute mood episodes in bipolar disorder. St. John's Wort and other factors like antidepressants and energy drinks were identified as triggers for manic/hypomanic episodes.

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2021·Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina·Kemal Durić, Selma Kovčić Hadžiabdić, Mahira Durić, et al

Efficacy and safety of three plant extracts based formulations of vagitories in the treatment of vaginitis: a randomized controlled trial.

RCTn = 210Womens Health

RCT of 210 women with vaginitis testing three herbal vagitory formulations based on extracts of St. John's wort, chamomile, calendula, yarrow, shepherd's purse, and tea tree oil. Tea tree oil-based vagitories showed better efficiency, while St. John's wort and five herbs-based vagitories were better tolerated in postmenopausal women. All formulations had a positive effect on vaginitis symptoms.

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2017·Journal of affective disorders·Qin Xiang Ng, Nandini Venkatanarayanan, Collin Yih Xian Ho

Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis.

Meta-analysisn = 3,808Mood

Meta-analysis of 27 clinical trials with 3808 patients comparing St John's wort to SSRIs for depression. St John's wort showed comparable response and remission rates, and significantly lower discontinuation rates compared to SSRIs, supporting its efficacy in ameliorating depressive symptoms.

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2016·Systematic Reviews·Eric A. Apaydin, A. R. Maher, R. Shanman, et al

A systematic review of St. John’s wort for major depressive disorder

Meta-analysisn = 6,993Mood

This systematic review evaluated the efficacy and safety of St. John's Wort (SJW) for treating Major Depressive Disorder (MDD) in adults. SJW was found to be more effective than placebo in improving depression symptoms and had fewer adverse events compared to antidepressants, with no significant difference in treatment effectiveness for mild and moderate depression.

Semantic ScholarRead on Semantic Scholar
2016·Neuropsychiatric Disease and Treatment·Yonghua Cui, Yi Zheng

A meta-analysis on the efficacy and safety of St John’s wort extract in depression therapy in comparison with selective serotonin reuptake inhibitors in adults

Meta-analysisn = 3,126Mood

Meta-analysis comparing the efficacy and safety of St John's wort extract to SSRIs in treating depression. St John's wort extract showed similar efficacy to SSRIs in clinical response and remission but had a significantly lower rate of adverse events, indicating superior safety.

Semantic ScholarRead on Semantic Scholar
2010·International clinical psychopharmacology·Siegfried Kasper, Markus Gastpar, Hans-Juergen Möller, et al

Better tolerability of St. John's wort extract WS 5570 compared to treatment with SSRIs: a reanalysis of data from controlled clinical trials in acute major depression.

Meta-analysisn = 1,661Mood

Reanalysis of data from four controlled clinical trials comparing the tolerability of St. John's wort extract WS 5570 to paroxetine and other SSRIs in 1661 outpatients with major depression. WS 5570 showed a comparable adverse event rate to placebo and significantly lower rates than paroxetine, with fewer side effects such as sedation and sexual dysfunction.

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2008·The Cochrane database of systematic reviews·Klaus Linde, Michael M Berner, Levente Kriston

St John's wort for major depression.

Systematic reviewn = 5,489Mood

Systematic review of 29 trials with 5489 patients comparing St. John's wort to placebo and standard antidepressants for major depression. St. John's wort was found to be superior to placebo and similarly effective as standard antidepressants, with fewer side effects.

PubMedRead on PubMed
2007·European archives of psychiatry and clinical neuroscience·S Kasper, M Gastpar, W E Müller, et al

Efficacy of St. John's wort extract WS 5570 in acute treatment of mild depression: a reanalysis of data from controlled clinical trials.

Meta-analysisn = 217Mood

Re-analysis of data from two double-blind, randomized, placebo-controlled clinical trials and a long-term study on St. John's wort extract WS 5570 for mild depression. Patients treated with WS 5570 showed significant decreases in HAMD scores compared to placebo, with higher rates of response and remission.

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2004·Fortschritte der Neurologie-Psychiatrie·Claudia Röder, Marion Schaefer, S Leucht

[Meta-analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John's Wort].

Meta-analysisn = 2,129Mood

Meta-analysis of 30 studies comparing St. John's Wort to placebo and synthetic antidepressants for mild to moderate depression. St. John's Wort showed significant advantage over placebo and similar effectiveness to synthetic antidepressants, with better results in mild to moderate depression and a favorable side-effect profile.

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2000·The Cochrane database of systematic reviews·K Linde, C D Mulrow

St John's wort for depression.

Systematic reviewn = 2,291Mood

Systematic review of 27 trials with 2291 patients comparing St. John's wort to placebo and standard antidepressants for depressive disorders. St. John's wort was significantly superior to placebo and similarly effective as standard antidepressants, with fewer side effects reported.

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1996·BMJ (Clinical research ed.)·K Linde, G Ramirez, C D Mulrow, et al

St John's wort for depression--an overview and meta-analysis of randomised clinical trials.

Meta-analysisn = 1,757Mood

Systematic review and meta-analysis of 23 randomised trials with 1757 outpatients with mild or moderately severe depressive disorders. Hypericum extracts were significantly superior to placebo and similarly effective as standard antidepressants, with fewer side effects.

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2024·Pain management nursing : official journal of the American Society of Pain Management Nurses·Deniz Zeynep Sönmez, Sultan Taşcı

The Effect of St. John's Wort Oil (Hypericum Perforatum L.) in Knee Osteoarthritis: A Randomized Controlled and Qualitative Study.

RCTn = 60Joint Bone Health Physical Performance

This study investigated the effect of St. John's Wort oil on pain intensity and physical functions in people with knee osteoarthritis. A single-blind, randomized, placebo-controlled trial with 60 patients showed that the experimental group treated with St. John's Wort oil had significantly lower pain and improved physical function compared to the placebo group.

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2020·Clinical oral investigations·Volkan Kaplan, Guzin Neda Hasanoglu Erbasar, Levent Cigerim, et al

Effect of St. John's wort oil and olive oil on the postoperative complications after third molar surgery: randomized, double-blind clinical trial.

RCTn = 90

This randomized, double-blind clinical trial evaluated the effects of St. John's wort oil and virgin olive oil on postoperative complications after third molar surgery, comparing them to chlorhexidine gluconate plus benzydamine hydrochloride mouthwash. No significant differences were found between the groups regarding pain, swelling, jaw function, or periodontal healing.

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2020·British journal of clinical pharmacology·Christina San San Tan, Shaun Wen Huey Lee

Warfarin and food, herbal or dietary supplement interactions: A systematic review.

Systematic review

Systematic review of 149 articles describing interactions between 78 herbs, food, or dietary supplements and warfarin. The review found that 57.7% of these substances potentiate warfarin effects, 29.5% inhibit, and 12.8% have limited impact. Some herbs and supplements, including St. John's Wort, are associated with increased bleeding risks.

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2019·Pharmacological research·Charles Awortwe, Henrike Bruckmueller, Ingolf Cascorbi

Interaction of herbal products with prescribed medications: A systematic review and meta-analysis.

Meta-analysis

Systematic review and meta-analysis of herb-drug interactions, focusing on St. John's Wort, Echinacea purpurea, and Green Tea. St. John's Wort decreased the AUC and clearance of midazolam, while Echinacea purpurea increased its clearance. Green Tea significantly decreased plasma concentration of nadolol. The study highlights the importance of understanding herb-drug interactions in medication plans.

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2018·Phytotherapy research : PTR·Catharine Avila, Dawn Whitten, Sue Evans

The safety of St John's wort (Hypericum perforatum) in pregnancy and lactation: A systematic review of rodent studies.

Systematic review

Systematic review of 10 rodent studies assessing the safety of St John's wort during the perinatal period. The review found significant methodological limitations in the studies, including lack of botanical verification and inadequate dosage rationale, rendering the results unreliable.

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2018·Archives of toxicology·Nadia Quignot, Witold Wiecek, Billy Amzal, et al

The Yin-Yang of CYP3A4: a Bayesian meta-analysis to quantify inhibition and induction of CYP3A4 metabolism in humans and refine uncertainty factors for mixture risk assessment.

Meta-analysis

Bayesian meta-analysis of 109 publications on CYP3A4 and Pgp substrate interactions with grapefruit juice and St. John's Wort. The study quantified inhibition and induction effects on pharmacokinetics, providing predictions for interaction magnitudes and refining uncertainty factors for chemical risk assessment.

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2017·PloS one·Songie Choi, Dal-Seok Oh, Ui Min Jerng

A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin.

Systematic review

Systematic review of pharmacokinetic and pharmacodynamic interactions between herbal medicines and warfarin. St John's wort and echinacea affected the PK parameters of warfarin, while ginseng, ginger, garlic, and cranberry had no significant effect. American ginseng altered the PD parameters of warfarin. Conflicting results were found for ginkgo and cranberry. The quality of evidence was low, and no major adverse events were reported.

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2017·Journal of clinical pharmacy and therapeutics·T-Y Li, W Liu, K Chen, et al

The influence of combination use of CYP450 inducers on the pharmacokinetics of voriconazole: a systematic review.

Systematic review

Systematic review assessing the influence of CYP450 inducers on the pharmacokinetics of voriconazole. St John's Wort significantly decreased the mean AUC of voriconazole, indicating a potential drug-supplement interaction. The review highlights the need for TDM and dose adjustment when voriconazole is co-administered with certain inducers.

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2017·Journal of alternative and complementary medicine (New York, N.Y.)·Gary N Asher, Gerald Gartlehner, Bradley N Gaynes, et al

Comparative Benefits and Harms of Complementary and Alternative Medicine Therapies for Initial Treatment of Major Depressive Disorder: Systematic Review and Meta-Analysis.

Meta-analysisMood

Systematic review and meta-analysis comparing the benefits and harms of CAM therapies, including acupuncture, omega-3 fatty acids, S-adenosyl methionine, and St. John's wort, with second-generation antidepressants for major depressive disorder. Found little difference in efficacy but noted higher treatment discontinuation due to adverse events for SSRIs compared to St. John's wort. Evidence quality was low or insufficient.

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2016·Rand health quarterly·A. R. Maher, S. Hempel, Eric A. Apaydin, et al

St. John's Wort for Major Depressive Disorder: A Systematic Review.

Systematic reviewMood

Systematic review of 35 RCTs evaluating St. John's Wort for major depressive disorder. Moderate evidence suggests SJW improves depression symptoms compared to placebo and is comparable to antidepressants. Adverse events were similar to placebo and fewer than with antidepressants, but confidence in this conclusion is limited.

Semantic ScholarRead on Semantic Scholar
2016·Contraception·Erin N Berry-Bibee, Myong-Jin Kim, Naomi K Tepper, et al

Co-administration of St. John's wort and hormonal contraceptives: a systematic review.

Systematic reviewWomens Health

Systematic review examining the interaction between St. John's wort and hormonal contraceptives. Evidence suggests increased risk of ovulation and breakthrough bleeding, indicating decreased contraceptive efficacy when co-administered with SJW. Pharmacokinetic evidence is mixed but suggests weak to moderate induction of COCs metabolism.

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2014·BMC Complementary and Alternative Medicine·M. Pirotta, Konstancja Densley, K. Forsdike, et al

St John’s wort use in Australian general practice patients with depressive symptoms: their characteristics and use of other health services

Cohort studyn = 7,432Mood

Secondary analysis of data from an Australian cohort study on depression, examining St John's Wort (SJW) use. SJW users were more likely to be depressed and use both conventional and complementary health services. No significant differences in satisfaction or trust in general practitioners were found between SJW users and non-users.

Semantic ScholarRead on Semantic Scholar
2014·Addiction (Abingdon, England)·Jamie Hartmann-Boyce, Lindsay F Stead, Kate Cahill, et al

Efficacy of interventions to combat tobacco addiction: Cochrane update of 2013 reviews.

Systematic review

Cochrane systematic review update on tobacco addiction interventions, including evidence that St John's Wort does not have a significant effect on long-term smoking cessation. The review also covers other interventions like varenicline, bupropion, and behavioral support.

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2012·Pharmacotherapy·Ashwini Nadkarni, Mark A Oldham, Mark Howard, et al

Drug-drug interactions between warfarin and psychotropics: updated review of the literature.

Systematic review

Systematic review of literature documenting interactions between warfarin and psychotropics, focusing on cytochrome P450 system and protein binding. St. John's Wort is noted to significantly decrease INR when used with warfarin, highlighting important drug-supplement interactions.

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2012·Homeopathy : the journal of the Faculty of Homeopathy·Christa Raak, Arndt Büssing, Georg Gassmann, et al

A systematic review and meta-analysis on the use of Hypericum perforatum (St. John's Wort) for pain conditions in dental practice.

Systematic reviewInflammation

Systematic review and meta-analysis on the use of Hypericum perforatum (St. John's Wort) for pain conditions in dental practice. The review found high heterogeneity in pain effects and an overall effect favoring Hypericum, but not statistically significant. The studies included also used Arnica montana, influencing results.

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2011·BMJ clinical evidence·Philip Hazell

Depression in children and adolescents.

Systematic reviewMood

Systematic review evaluating the effectiveness and safety of various interventions for depression in children and adolescents, including pharmacological, psychological, and complementary treatments. St John's Wort (Hypericum perforatum) is among the interventions reviewed.

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2010·Journal of psychiatric research·Marcus Mannel, Ulrike Kuhn, Ulrich Schmidt, et al

St. John's wort extract LI160 for the treatment of depression with atypical features - a double-blind, randomized, and placebo-controlled trial.

RCTn = 200Mood

An 8-week double-blind, placebo-controlled, randomized trial of 600 mg St. John's wort extract LI160 vs. placebo in 200 patients with atypical depression. The study found significant improvements in depression scores for LI160, particularly in moderately depressed patients, supporting its beneficial effect in atypical depression.

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2009·BMJ clinical evidence·Philip Hazell

Depression in children and adolescents.

Systematic reviewMood

Systematic review evaluating the effectiveness and safety of various interventions for depression in children and adolescents, including pharmacological, psychological, and complementary treatments. St John's Wort (Hypericum perforatum) is among the substances reviewed.

PubMedRead on PubMed
2009·Drugs·Angelo A Izzo, Edzard Ernst

Interactions between herbal medicines and prescribed drugs: an updated systematic review.

Systematic review

Systematic review of interactions between herbal medicines and prescribed drugs. St John's wort, ginkgo, ginseng, garlic, echinacea, saw palmetto, and kava were reviewed. St John's wort notably reduces plasma concentrations of various drugs via cytochrome P450 and P-glycoprotein induction, with potential serious clinical consequences.

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2009·Journal of alternative and complementary medicine (New York, N.Y.)·Jerome Sarris, David J Kavanagh

Kava and St. John's Wort: current evidence for use in mood and anxiety disorders.

Systematic reviewMood Stress

Systematic review of kava and St. John's Wort for mood and anxiety disorders. Evidence supports St. John's Wort for mild-moderate depression and kava for generalized anxiety. Weak evidence for St. John's Wort in seasonal affective disorder. No human trials for kava in other affective disorders.

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2008·Progress in neuro-psychopharmacology & biological psychiatry·Roja Rahimi, Shekoufeh Nikfar, Mohammad Abdollahi

Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis.

Meta-analysisMood

Meta-analysis comparing the efficacy and tolerability of Hypericum perforatum (St. John's Wort) with selective serotonin reuptake inhibitors (SSRIs) in managing major depressive disorder. The analysis found no significant differences in efficacy or adverse events between Hypericum and SSRIs, but Hypericum had a lower withdrawal rate due to adverse events.

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2008·Current drug metabolism·Shu-Feng Zhou, Xinsheng Lai

An update on clinical drug interactions with the herbal antidepressant St. John's wort.

Systematic review

Systematic review of clinical drug interactions with St. John's Wort (SJW), highlighting its ability to alter pharmacokinetics and clinical response of various drugs. SJW is a potent inducer of CYP3A4 and P-gp, leading to decreased drug concentrations and potential adverse reactions when combined with certain medications.

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2006·BMC medicine·Siegfried Kasper, Ion-George Anghelescu, Armin Szegedi, et al

Superior efficacy of St John's wort extract WS 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298].

RCTn = 332Mood

This randomized, double-blind, placebo-controlled, multi-center trial assessed the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS 5570 at doses of 600 mg/day and 1200 mg/day in patients with mild to moderate major depression. Both doses were found to be more effective than placebo in reducing depression scores, with a higher remission rate in the 1200 mg/day group. The incidence of adverse events was low and consistent with known profiles.

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2006·British journal of clinical pharmacology·D L Whitten, S P Myers, J A Hawrelak, et al

The effect of St John's wort extracts on CYP3A: a systematic review of prospective clinical trials.

Systematic review

Systematic review of clinical trials assessing the effect of St John's wort extracts on CYP3A metabolism. High-dose hyperforin extracts were found to induce CYP3A, while low-dose extracts showed no significant effect.

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2006·Holistic nursing practice·Kimberly Clement, Catherine R Covertson, Mary Jane Johnson, et al

St. John's wort and the treatment of mild to moderate depression: a systematic review.

Systematic reviewMood

Systematic review of randomized controlled trials assessing the efficacy of St. John's Wort in treating mild to moderate depression. All studies showed significant improvements in depression scores for those taking St. John's Wort compared to placebo or pharmaceutical antidepressants.

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2005·The Cochrane database of systematic reviews·K Linde, C D Mulrow, M Berner, et al

St John's wort for depression.

Meta-analysisMood

Meta-analysis of 37 trials comparing St. John's wort extracts to placebo and standard antidepressants in treating depressive disorders. Results showed mixed effectiveness, with some trials indicating minimal benefits and others showing similar effects to standard antidepressants. Adverse effects were less frequent with St. John's wort compared to older antidepressants.

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2005·The British journal of psychiatry : the journal of mental science·Klaus Linde, Michael Berner, Matthias Egger, et al

St John's wort for depression: meta-analysis of randomised controlled trials.

Meta-analysisMood

Systematic review and meta-analysis of 37 double-blind RCTs comparing Hypericum extracts with placebo or standard antidepressants in adults with depressive disorders. Larger trials showed minor effects over placebo in major depression, while smaller trials showed marked effects. Hypericum had similar effects to standard antidepressants.

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2004·The Journal of clinical psychiatry·Lars Knüppel, Klaus Linde

Adverse effects of St. John's Wort: a systematic review.

Systematic reviewn = 100

Systematic review of clinical evidence on the safety and tolerability of hypericum extracts. Data from 35 double-blind randomized trials showed similar dropout and adverse effects rates to placebo, lower than older antidepressants, and slightly lower than SSRIs. Observational studies with 35,562 patients reported dropout rates due to adverse effects ranging from 0% to 5.7%. Interactions with drugs, particularly cyclosporine, were noted as relevant adverse effects.

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2004·The Journal of clinical psychiatry·Ursula Werneke, Oded Horn, David M Taylor

How effective is St John's wort? The evidence revisited.

Meta-analysisMood

Meta-analysis reevaluating the effectiveness of St. John's wort as an antidepressant. Recent studies show smaller effect sizes compared to earlier studies, with a reduced risk ratio in the updated analysis. Publication bias and small-study effects were assessed, suggesting St. John's wort may be less effective than previously assumed.

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2004·BMJ (Clinical research ed.)·Edward Mills, Victor M Montori, Ping Wu, et al

Interaction of St John's wort with conventional drugs: systematic review of clinical trials.

Systematic review

Systematic review of 22 pharmacokinetic trials examining the interaction of St John's wort with conventional drugs. Most trials found a decrease in the systemic bioavailability of conventional drugs when taken with St John's wort, indicating potential drug-supplement interactions.

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2003·Psychosomatics·Paul Hammerness, Ethan Basch, Catherine Ulbricht, et al

St John's wort: a systematic review of adverse effects and drug interactions for the consultation psychiatrist.

Systematic review

Systematic review of St. John's wort, focusing on its adverse effects and drug interactions. The review discusses its effectiveness compared to placebo and tricyclic antidepressants for mild-to-moderate depression, and highlights significant drug interactions.

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2002·The American journal of psychiatry·Y Lecrubier, G Clerc, R Didi, et al

Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial.

RCTn = 375Mood

Double-blind, randomized, placebo-controlled trial with 375 patients investigating the antidepressant efficacy and safety of 300 mg t.i.d. of Hypericum perforatum extract WS 5570. WS 5570 produced a significantly greater reduction in Hamilton depression scale scores compared to placebo, with more patients achieving treatment response or remission. It was effective in reducing depression-related core symptoms and had comparable adverse events to placebo.

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2002·JAMA·Jonathan RT Davidson, Kishore M Gadde, et al

Effect of Hypericum perforatum (St John's wort) in major depressive disorder: a randomized controlled trial.

RCTn = 340Mood -

Double-blind, randomized, placebo-controlled trial of 340 adult outpatients with major depression testing the efficacy and safety of Hypericum perforatum (St John's wort) compared to placebo and sertraline. The study found no significant difference in efficacy between H perforatum and placebo in improving depression scores, suggesting no effect of H perforatum in moderately severe major depression.

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2002·Archives of surgery (Chicago, Ill. : 1960)·E Ernst

St John's Wort supplements endanger the success of organ transplantation.

Systematic review

Systematic review of interactions between St John's Wort and cyclosporine, identifying 11 case reports and 2 case series. The review concludes that St John's Wort decreases cyclosporine blood levels, potentially leading to transplant rejection.

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2002·British journal of clinical pharmacology·L Henderson, Q Y Yue, C Bergquist, et al

St John's wort (Hypericum perforatum): drug interactions and clinical outcomes.

Systematic review

Systematic review identifying clinically significant interactions between St John's wort and various prescribed medicines, including warfarin, cyclosporin, and oral contraceptives. These interactions are likely due to the induction of cytochrome P450 isoenzymes and P-glycoprotein by constituents in St John's wort, leading to decreased drug concentrations or effects.

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2001·International clinical psychopharmacology·E Whiskey, U Werneke, D Taylor

A systematic review and meta-analysis of Hypericum perforatum in depression: a comprehensive clinical review.

Meta-analysisMood

Systematic review and meta-analysis of 22 RCTs on St John's wort for depression. St John's wort was significantly more effective than placebo and had similar effectiveness to standard antidepressants, with fewer adverse effects.

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2000·BMJ (Clinical research ed.)·H Woelk

Comparison of St John's wort and imipramine for treating depression: randomised controlled trial.

RCTn = 324Mood

RCT comparing the efficacy and tolerability of St John's wort extract (Hypericum perforatum) with imipramine in 324 outpatients with mild to moderate depression. Both treatments showed similar reductions in depression scores, but St John's wort had better tolerability and fewer adverse events.

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2000·Archives of internal medicine·B Gaster, J Holroyd

St John's wort for depression: a systematic review.

Systematic reviewMood

Systematic review of randomized, controlled, double-blind trials assessing the efficacy, safety, and availability of St John's wort for depression. Found that St John's wort is more effective than placebo for mild to moderate depression, with low rates of side effects. More data needed for severe depression and comparison with other antidepressants.

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2025·Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society·Sevinç Yıldırım, Hatice Kaya, Öner Süzer

The Effects of St. John's Wort on Healing of Stages 1 and 2 Pressure Injuries: A Randomized Controlled Trial.

RCTn = 48

RCT evaluating the effects of topical St. John's wort oil on wound healing in Stages 1 and 2 pressure injuries in a nursing home setting. No significant differences in wound healing outcomes were found between the intervention and control groups.

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2024·Clinical pharmacology in drug development·Katja S Gümüs, Anna Teegelbekkers, Max Sauter, et al

Effect of Tacrolimus Formulation (Prolonged-Release vs Immediate-Release) on Its Susceptibility to Drug-Drug Interactions with St. John's Wort.

RCTn = 18

Randomized crossover trial with 18 healthy volunteers comparing the effect of St. John's Wort on the pharmacokinetics of immediate-release and prolonged-release tacrolimus. St. John's Wort decreased exposure and maximum concentration of both tacrolimus formulations, with no statistical difference between them. The interaction was less pronounced in individuals with higher baseline CYP3A4 activity.

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2023·Nutraceuticals·Efstratios Christodoulou, Ana Meca, A. Koutelidakis

Herbal Infusions as a Part of the Mediterranean Diet and Their Association with Psychological Resilience: The Paradigm of Greek Mountain Tea

Cross-sectionaln = 398Mental Clarity

Cross-sectional study of 398 healthy adults in Greece exploring the relationship between herbal infusions and the Mediterranean Diet, and their association with psychological resilience. Greek mountain tea, St John's wort, and green tea were associated with higher levels of psychological resilience.

Semantic ScholarRead on Semantic Scholar
2023·Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]·Bo Ri Kim, Minjae Kim, Jung-Im Na, et al

A Randomized Split-Face Study of Photodynamic Therapy With St. John's Wort and Indole-3-Acetic Acid for the Treatment of Acne.

RCTn = 31Skin Hair Health

A randomized split-face study comparing the efficacy and safety of St. John's Wort-photodynamic therapy (PDT) with indole-3-acetic acid-PDT for acne treatment. SJW-PDT significantly reduced acne lesion counts, sebum secretion, erythema index, roughness, and wrinkles, showing it as a safe and effective treatment option for acne and skin rejuvenation.

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2020·Anesthesiology·Michael J Loughren, Evan D Kharasch, Megan C Kelton-Rehkopf, et al

Influence of St. John's Wort on Intravenous Fentanyl Pharmacokinetics, Pharmacodynamics, and Clinical Effects: A Randomized Clinical Trial.

RCTn = 16

Randomized clinical trial evaluating the effects of St. John's wort on intravenous fentanyl pharmacokinetics, pharmacodynamics, and clinical effects in healthy volunteers. St. John's wort did not alter fentanyl pharmacokinetics, pharmacodynamics, or clinical effects, suggesting no effect on hepatic clearance or blood-brain barrier efflux.

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2014·The Cochrane database of systematic reviews·John R Hughes, Lindsay F Stead, Jamie Hartmann-Boyce, et al

Antidepressants for smoking cessation.

Meta-analysisn = 13

Meta-analysis assessing the effect and safety of antidepressant medications, including St. John's Wort, for smoking cessation. The analysis found no significant effect of St. John's Wort on smoking cessation.

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2010·Journal of alternative and complementary medicine (New York, N.Y.)·Amit Sood, Jon O Ebbert, Kavita Prasad, et al

A randomized clinical trial of St. John's wort for smoking cessation.

RCTn = 118

Randomized, blinded, placebo-controlled trial of St. John's Wort (SJW) for smoking cessation in 118 subjects. No significant differences in abstinence rates were observed between SJW dose groups and placebo. SJW did not attenuate withdrawal symptoms, and no significant side-effects were noted.

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2009·Menopause (New York, N.Y.)·M Diana van Die, Henry G Burger, Kerry M Bone, et al

Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial.

RCTn = 100Womens Health -

A double-blind, randomized, placebo-controlled trial evaluated the effectiveness of a combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus in managing menopausal symptoms in 100 women. The study found no significant differences between the herbal combination and placebo for hot flush episodes or other endpoints. Both groups showed improvements, but the herbal combination was not superior to placebo.

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2009·The American journal of gastroenterology·Yuri A Saito, Enrique Rey, Ann E Almazar-Elder, et al

A randomized, double-blind, placebo-controlled trial of St John's wort for treating irritable bowel syndrome.

RCTn = 70Gut Health

A randomized, double-blind, placebo-controlled trial evaluated the efficacy of St John's Wort (SJW) in treating irritable bowel syndrome (IBS) over 12 weeks. The study found that SJW was less effective than placebo in improving bowel symptom scores and other IBS-related outcomes.

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2008·JAMA·Wendy Weber, Ann Vander Stoep, Rachelle L McCarty, et al

Hypericum perforatum (St John's wort) for attention-deficit/hyperactivity disorder in children and adolescents: a randomized controlled trial.

RCTn = 54Focus -

Randomized, double-blind, placebo-controlled trial of 54 children with ADHD testing 300 mg of St. John's Wort (Hypericum perforatum) standardized to 0.3% hypericin. No significant improvement in ADHD symptoms was observed compared to placebo over 8 weeks.

PubMedRead on PubMed
2006·Phytomedicine : international journal of phytotherapy and phytopharmacology·C Randløv, J Mehlsen, C F Thomsen, et al

The efficacy of St. John's Wort in patients with minor depressive symptoms or dysthymia--a double-blind placebo-controlled study.

RCTn = 150Mood

Double-blind placebo-controlled study of St. John's Wort (Hypericum) in 150 patients with minor depressive symptoms or dysthymia. The study found significant improvement in mood for non-dysthymic patients treated with Hypericum, as measured by BDI and VAS, though HAM-D showed only a tendency towards significance.

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2005·Journal of clinical psychopharmacology·Maurizio Fava, Jonathan Alpert, Andrew A Nierenberg, et al

A Double-blind, randomized trial of St John's wort, fluoxetine, and placebo in major depressive disorder.

RCTn = 135Mood

This double-blind, randomized trial compared the antidepressant efficacy and safety of St John's wort, fluoxetine, and placebo in patients with major depressive disorder. St John's wort showed significantly lower mean HAMD-17 scores compared to fluoxetine and a trend towards superiority over placebo, with higher remission rates. It was safe and well tolerated.

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2005·Planta medica·Gerhard Arold, Frank Donath, Agathe Maurer, et al

No relevant interaction with alprazolam, caffeine, tolbutamide, and digoxin by treatment with a low-hyperforin St John's wort extract.

RCTn = 56

Two randomized, placebo-controlled studies evaluated the pharmacokinetic interaction between a low-hyperforin St John's wort extract and alprazolam, caffeine, tolbutamide, and digoxin in 56 healthy volunteers. No statistically significant differences were found in the primary kinetic parameters between the placebo and SJW groups, suggesting clinically irrelevant interactions with the low-hyperforin SJW extract.

PubMedRead on PubMed
2004·Psychosomatic medicine·Thomas Müller, Marcus Mannel, Harald Murck, et al

Treatment of somatoform disorders with St. John's wort: a randomized, double-blind and placebo-controlled trial.

RCTn = 184

RCT of 184 outpatients with somatoform disorders comparing 600 mg daily of St. John's Wort extract LI 160 to placebo for 6 weeks. St. John's Wort showed statistically significant superiority over placebo in efficacy measures, with 45.4% of patients classified as responders compared to 20.9% with placebo. Tolerability was equivalent to placebo.

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2004·Clinical pharmacology and therapeutics·Silke C Mueller, Bernhard Uehleke, Heike Woehling, et al

Effect of St John's wort dose and preparations on the pharmacokinetics of digoxin.

RCTn = 96

A randomized, placebo-controlled study in 96 healthy volunteers evaluated the pharmacokinetic interaction of various St John's wort formulations and doses with digoxin. High-dose hyperforin-rich extracts significantly reduced digoxin's pharmacokinetic parameters, while other formulations showed no significant interaction.

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2003·Phytomedicine : international journal of phytotherapy and phytopharmacology·Diethard Müller, T Pfeil, V von den Driesch

Treating depression comorbid with anxiety--results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses.

RCTMood Stress

Open, practice-oriented study evaluating high-dose combination therapy of St John's wort and valerian extract for depression comorbid with anxiety. The combination therapy improved anxiety symptoms more quickly than St John's wort monotherapy and was well tolerated.

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2002·Psychopharmacology·Hans-Peter Volz, Harald Murck, Siegfried Kasper, et al

St John's wort extract (LI 160) in somatoform disorders: results of a placebo-controlled trial.

RCTn = 151Mood

This multicentre, randomised, placebo-controlled trial studied the efficacy of St John's wort extract (LI 160) in 151 out-patients with somatoform disorders. The extract showed superior efficacy in reducing somatic anxiety as measured by the Hamilton Anxiety Scale compared to placebo, with excellent tolerability.

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2002·Canadian family physician Medecin de famille canadien·Gerald van Gurp, Greg B Meterissian, Laura N Haiek, et al

St John's wort or sertraline? Randomized controlled trial in primary care.

RCTn = 87Mood

Double-blind, randomized 12-week trial comparing St John's wort (SJW) and sertraline in 87 primary care patients with major depression. No significant differences in depression scores were found between the groups, but SJW had fewer side effects, suggesting it as a good first choice for this population.

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2002·Clinical pharmacology and therapeutics·Zaiqi Wang, Mitchell A Hamman, Shiew-Mei Huang, et al

Effect of St John's wort on the pharmacokinetics of fexofenadine.

RCT

A 3-period, open-label study examined the effect of St John's wort on the pharmacokinetics of fexofenadine. A single dose of St John's wort increased the maximum plasma concentration of fexofenadine by 45% and decreased oral clearance by 20%. Long-term administration reversed these effects, decreasing maximum plasma concentration by 35% and increasing oral clearance by 47%.

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2001·Pain·Søren H Sindrup, Claus Madsen, Flemming W Bach, et al

St. John's wort has no effect on pain in polyneuropathy.

RCTn = 54

Randomized, double-blind, placebo-controlled cross-over study testing St. John's wort for pain relief in polyneuropathy. Fifty-four patients participated, with no significant effect on pain compared to placebo.

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2000·Lancet (London, England)·S C Piscitelli, A H Burstein, D Chaitt, et al

Indinavir concentrations and St John's wort.

RCT

RCT showing that St John's Wort reduced the area under the curve of the HIV-1 protease inhibitor indinavir by a mean of 57% and decreased the extrapolated 8-hour indinavir trough by 81% in healthy volunteers. This reduction in indinavir exposure could lead to drug resistance and treatment failure.

PubMedRead on PubMed
1999·The Journal of nervous and mental disease·H L Kim, J Streltzer, D Goebert

St. John's wort for depression: a meta-analysis of well-defined clinical trials.

Meta-analysisMood

Meta-analysis of well-defined clinical trials assessing St. John's wort (Hypericum perforatum) for depression. Hypericum was 1.5 times more likely to result in an antidepressant response than placebo and was equivalent to tricyclic antidepressants. The meta-analysis also showed a higher dropout rate and more severe side effects in the TCA group. Design problems in existing studies prevent definitive conclusions about its effectiveness.

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1998·European journal of clinical pharmacology·E Ernst, J I Rand, J Barnes, et al

Adverse effects profile of the herbal antidepressant St. John's wort (Hypericum perforatum L.).

Systematic review

Systematic review of adverse drug reactions associated with St. John's wort for treating mild to moderate depression. The herb is generally well tolerated, with adverse reactions similar to placebo. Common effects include gastrointestinal symptoms, dizziness, and tiredness, with rare cases of photosensitivity.

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1998·Current medical research and opinion·H Hippius

St John's Wort (Hypericum perforatum)--a herbal antidepressant.

Meta-analysisMood

Meta-analysis of clinical studies indicating that St John's wort (Hypericum perforatum) has antidepressant effects, with a response rate of 60-70% in mild and moderate depression. The preparations are well tolerated with rare adverse reactions, making them suitable for outpatient practice.

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2025·Applied Sciences·Ewelina Błońska-Sikora, Agnieszka Zielińska, Natalia Dobros, et al

Polyphenol and Flavonoid Content and Antioxidant Activity of Hypericum perforatum L. (St. John’s Wort) Extracts for Potential Pharmaceutical and Cosmetic Applications

StudySkin Hair Health

The study assessed the antioxidant activity and polyphenolic content of two commercial St. John's Wort extracts used in cosmetics. The extracts demonstrated free radical-scavenging properties, indicating potential for cellular protection against oxidative stress.

Semantic ScholarRead on Semantic Scholar
2023·Open Chemistry·Paweł Rychlewski, Elham Kamgar, S. Mildner-Szkudlarz, et al

Determination of the contents of bioactive compounds in St. John’s wort (Hypericum perforatum): Comparison of commercial and wild samples

Study

The study analyzed the content of flavonoids and antioxidant activity in commercial and wild-grown St. John's Wort samples using LC–MS/MS. It evaluated functional constituents like phenolic acids, quercetin, rutin, pseudohypericin, and hypericin. Wild plants showed higher amounts of compounds with antidepressant effects than commercially grown plants.

Semantic ScholarRead on Semantic Scholar
2020·British Journal of Clinical Pharmacology·Irene Scholz, E. Liakoni, F. Hammann, et al

Effects of Hypericum perforatum (St John's wort) on the pharmacokinetics and pharmacodynamics of rivaroxaban in humans

Study

The study investigates the influence of Hypericum perforatum (St John's wort) on the pharmacokinetics and pharmacodynamics of rivaroxaban, focusing on its role as a cytochrome P450 CYP3A4 and P-glycoprotein (P-gp) inducer.

Semantic ScholarRead on Semantic Scholar
2020·Molecules·Chia-Hung Kuo, Y. Chou, Kuo-Chun Liao, et al

Optimization of Light Intensity, Temperature, and Nutrients to Enhance the Bioactive Content of Hyperforin and Rutin in St. John’s Wort

Study

The study used design of experiments and response surface methodology to optimize light intensity, temperature, and nutrient conditions for enhancing hyperforin and rutin content in St. John's wort. Hyperforin and rutin contents were significantly influenced by temperature and light intensity, while nutrient solution concentration had little effect. The study provides optimal conditions for bioactive compound accumulation in St. John's wort.

Semantic ScholarRead on Semantic Scholar
2018·Journal of psychopharmacology (Oxford, England)·Matthew B Warren, Philip J Cowen, Catherine J Harmer

Subchronic treatment with St John's wort produces a positive shift in emotional processing in healthy volunteers.

RCTn = 48Mood

RCT with 48 healthy participants given St John's wort or placebo for seven days. St John's wort treatment produced positive shifts in emotional processing, similar to other antidepressants, by reducing recognition of disgusted faces and increasing memory for positive words.

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2018·British journal of clinical pharmacology·Andrea Huppertz, Lars Werntz, Andreas D Meid, et al

Rivaroxaban and macitentan can be coadministered without dose adjustment but the combination of rivaroxaban and St John's wort should be avoided.

RCTn = 12

Phase I clinical trial with 12 healthy volunteers assessing the interaction of macitentan and rivaroxaban, and the effect of St John's Wort on their pharmacokinetics. St John's Wort significantly increased CYP3A activity and reduced exposure to rivaroxaban and macitentan, suggesting the combination of St John's Wort with rivaroxaban should be avoided.

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2015·British journal of clinical pharmacology·Tore Bjerregaard Stage, Rasmus Steen Pedersen, Per Damkier, et al

Intake of St John's wort improves the glucose tolerance in healthy subjects who ingest metformin compared with metformin alone.

RCTn = 20

Open cross-over study in 20 healthy male subjects examining the interaction between St John's wort and metformin. St John's wort decreased the renal clearance of metformin and improved glucose tolerance by enhancing insulin secretion.

PubMedRead on PubMed
2015·Archives of toxicology·Nicolas Hohmann, Anna Maus, Alexandra Carls, et al

St. John's wort treatment in women bears risks beyond pharmacokinetic drug interactions.

RCTn = 12

Phase I trial assessing dose-dependent metabolic effects of St. John's wort co-administered with rifampicin in 12 healthy volunteers. Five of six female participants developed ambient temperature-dependent allodynia and paresthesia in sun-exposed areas, with symptoms persisting and leading to phototoxic erythrodermia. These adverse effects were not observed in male participants.

PubMedRead on PubMed
2014·Clinical pharmacokinetics·Andrew K L Goey, Irma Meijerman, Hilde Rosing, et al

The effect of St John's wort on the pharmacokinetics of docetaxel.

RCTn = 10

RCT investigating the pharmacokinetic interaction between St John's Wort (SJW) and docetaxel in 10 cancer patients. SJW supplementation significantly decreased the mean area under the docetaxel plasma concentration-time curve and increased docetaxel clearance, suggesting potential undertreatment of cancer patients when used concomitantly.

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2012·Jundishapur Journal of Natural Pharmaceutical Products·S. Pakseresht, H. Boustani, M. Azemi, et al

Evaluation of Pharmaceutical Products of St. John’s Wort Efficacy Added on Tricyclic Antidepressants in treating Major Depressive Disorder: A Double Blind Randomized Control Trial

RCTn = 40Mood Sleep Energy

Double blind randomized controlled trial evaluating the efficacy of St. John's Wort (Hypericum perforatum) added to tricyclic antidepressants in treating major depressive disorder. The study included 40 patients and found significant improvement in depression, sleep quality, and energy levels in the St. John's Wort group compared to placebo.

Semantic ScholarRead on Semantic Scholar
2011·Fundamental & clinical pharmacology·Marko A Peltoniemi, Teijo I Saari, Nora M Hagelberg, et al

St John's wort greatly decreases the plasma concentrations of oral S-ketamine.

RCTn = 12

Randomized cross-over study with 12 healthy subjects to investigate the effect of St John's wort on the pharmacokinetics and pharmacodynamics of oral S-ketamine. St John's wort significantly decreased the plasma concentrations of ketamine and its major metabolite norketamine, suggesting a potential interaction that could render usual doses of S-ketamine ineffective.

PubMedRead on PubMed
2010·European journal of pain (London, England)·Tuija H Nieminen, Nora M Hagelberg, Teijo I Saari, et al

St John's wort greatly reduces the concentrations of oral oxycodone.

RCTn = 12

Placebo-controlled, randomized, cross-over study with 12 healthy participants assessing the effect of St John's wort on oxycodone metabolism. St John's wort administration reduced oxycodone plasma concentrations by 50% and decreased its elimination half-life. The self-reported drug effect of oxycodone decreased significantly, indicating a potential drug-supplement interaction.

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2009·Human psychopharmacology·Jerome Sarris, David J Kavanagh, Gary Deed, et al

St. John's wort and Kava in treating major depressive disorder with comorbid anxiety: a randomised double-blind placebo-controlled pilot trial.

RCTn = 28Mood Stress -

RCT of 28 adults with major depressive disorder and comorbid anxiety testing St. John's Wort and Kava against placebo. The combination showed a significant reduction in depression scores in the first phase but no significant effects on anxiety or quality of life.

PubMedRead on PubMed
2009·European Journal of Clinical Pharmacology·L. Will-Shahab, S. Bauer, U. Kunter, et al

St John’s wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive

RCTn = 16

RCT investigating the effects of St John's wort extract (Ze 117) on the pharmacokinetics of ethinylestradiol and 3-ketodesogestrel in 16 healthy female volunteers. The study found that Ze 117 does not significantly alter the pharmacokinetics of the hormonal components of a low-dose oral contraceptive.

Semantic ScholarRead on Semantic Scholar
2009·Journal of alternative and complementary medicine (New York, N.Y.)·Margaret Diana van Die, Kerry M Bone, Henry G Burger, et al

Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis.

RCTn = 14Womens Health Mood Stress

A double-blind, randomized, placebo-controlled trial evaluated the effectiveness of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women. The herbal combination was superior to placebo for total PMS-like scores and specific subclusters, suggesting potential clinical application for managing PMS-like symptoms.

PubMedRead on PubMed
2007·European journal of clinical pharmacology·L Andrén, A Andreasson, R Eggertsen

Interaction between a commercially available St. John's wort product (Movina) and atorvastatin in patients with hypercholesterolemia.

RCTn = 16Heart Health

RCT assessing the interaction between St. John's wort (Movina) and atorvastatin in 16 patients with hypercholesterolemia. St. John's wort significantly increased LDL and total cholesterol levels compared to control, indicating a negative interaction with atorvastatin.

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2007·The Annals of pharmacotherapy·Edward C Bell, William R Ravis, Hui Min Chan, et al

Lack of pharmacokinetic interaction between St. John's wort and prednisone.

RCTn = 8

This study examined the effects of long-term St. John's Wort administration on the pharmacokinetics of prednisone and prednisolone in eight male subjects. After 28 days of SJW treatment, there were no significant alterations in the pharmacokinetic parameters for prednisone or prednisolone.

PubMedRead on PubMed
2007·The Annals of pharmacotherapy·Edward C Bell, William R Ravis, Kimberly Braxton Lloyd, et al

Effects of St. John's wort supplementation on ibuprofen pharmacokinetics.

RCTn = 8

RCT examining the effect of 3 weeks of St. John's wort administration on the pharmacokinetics of ibuprofen in 8 male subjects. St. John's wort had no significant effects on the C(max) and AUC of either ibuprofen stereoisomer, though it reduced the mean residence time of S(+)-ibuprofen by 31%. No ibuprofen dose adjustments are necessary when co-administered with St. John's wort.

PubMedRead on PubMed
2006·Journal of clinical pharmacology·Xuemin Jiang, Elaine Y L Blair, Andrew J McLachlan

Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach.

RCTn = 24

This study investigated herb-drug interactions with warfarin in 24 healthy subjects using a population pharmacokinetic-pharmacodynamic modeling approach. St John's wort significantly increased S-warfarin clearance, while Asian ginseng produced a moderate increase. Ginkgo and ginger did not affect warfarin pharmacokinetics. None of the herbs had a direct effect on warfarin pharmacodynamics.

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2006·Complementary therapies in medicine·Silvana Lawvere, Martin C Mahoney, K Michael Cummings, et al

A Phase II study of St. John's Wort for smoking cessation.

RCTn = 24

Phase II study examining the feasibility and efficacy of St. John's Wort for smoking cessation. Among 24 evaluable subjects, the 12-week quit rate was 37.5%. SJW was generally well tolerated and may be effective in maintaining smoking cessation.

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2006·Pharmacopsychiatry·M Franklin, S Hafizi, A Reed, et al

Effect of sub-chronic treatment with Jarsin (extract of St John's wort, Hypericum perforatum) at two dose levels on evening salivary melatonin and cortisol concentrations in healthy male volunteers.

RCTn = 20

RCT of 20 healthy male volunteers given low or high doses of Jarsin (St John's Wort extract) for 7 days. Low dose increased salivary cortisol, while high dose had no effect. Melatonin levels were unaffected by either dose.

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2005·Journal of clinical psychopharmacology·Kenneth A Kobak, Leslie V H Taylor, Gemma Warner, et al

St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study.

RCTn = 40Mood -

Pilot RCT of 40 subjects with social anxiety disorder comparing 12 weeks of St. John's Wort to placebo. No significant difference was found between the groups on the Liebowitz Social Anxiety Scale, suggesting no efficacy of SJW in social phobia.

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2005·Drugs & aging·Bill J Gurley, Stephanie F Gardner, Martha A Hubbard, et al

Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and Ginkgo biloba.

RCTn = 12

RCT assessing the effects of St John's wort, garlic oil, Panax ginseng, and Ginkgo biloba on cytochrome P450 activity in elderly subjects. St John's wort significantly induced CYP3A4 and CYP2E1 activity, while garlic oil inhibited CYP2E1. P. ginseng showed a statistically significant but clinically irrelevant inhibition of CYP2D6. No effects on CYP1A2 activity were observed.

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2004·Clinical pharmacology and therapeutics·Christoph Schroeder, Jens Tank, David S Goldstein, et al

Influence of St John's wort on catecholamine turnover and cardiovascular regulation in humans.

RCTn = 16

Double-blind, randomized, placebo-controlled, crossover study with 16 healthy subjects examining the effects of St John's wort on catecholamine turnover and cardiovascular regulation. St John's wort had no effect on blood pressure, heart rate, or norepinephrine levels, but increased plasma DOPAC concentrations, suggesting a potential novel mode of action.

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2004·British journal of clinical pharmacology·Atsuhiro Kawaguchi, Masami Ohmori, Shu-Ichi Tsuruoka, et al

Drug interaction between St John's Wort and quazepam.

RCTn = 13

RCT examining the interaction between St John's Wort (SJW) and quazepam in 13 healthy subjects. SJW decreased plasma quazepam concentrations by enhancing CYP3A4 activity but did not influence the pharmacodynamic effects of quazepam.

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