As a herb, St John's wort is often viewed as a natural product. This quality can influence users into believing it is completely safe to take.
Compared to traditional antidepressants, St John's wort is a product of nature; it does not have the patents and subsequent research devoted to them.
However, St John's wort as a herbal remedy has stood the test of time over two millenia.
Modern research appears to support the notion that St John's wort is a safe treatment for depression; although it's effectiveness for more severe depression is questioned.
The dangers surrounding St John's wort are concerned with:
Unlike Germany and Ireland where St John's wort is only available by prescription, in most countries it is available over the counter. It is advisable to purchase from reputable sources.
Photosensitization refers to the eyes and skin becoming over sensitive. If photosensitization occurs, it is much easier to get sunburn. If this side effect is mild, suncream should be worn on bright days.
In severe cases, advice from a doctor should be sought who may advise switching to another treatment option.
Serotonin syndrome can be a very serious condition in which serotonin levels are raised too high, causing a range of symptoms which are barely perceptible to fatal.
Symptoms of serotonin syndrome include:
If users of St John's wort are already taking another form of antidepressant, they may be more likely to develop this condition.
For example, St John's wort can interfere with drugs used during organ transplant operations; this can lead to dire consequences (see also, 'St John's wort interacts with drugs').
There is limited research into the effects of St John's wort on pregnancy and breast feeding. Women should not take St John's wort whilst pregnant or breast feeding as the risks are not understood.
St John's wort is not a proven treatment for severe depression; there is conflicting evidence as to its effectiveness . If a person with severe depression takes St John's wort and it does not benefit them, suicide could be a potential consequence.
Treatment options for depression (especially severe depression) should be discussed with a doctor first.
These include Alzheimer's disease, in which St John's wort can worsen or cause psychotic symptoms.
St John's wort may also worsen symptoms of schizophrenia, manic depression (bipolar disorder) causing mania, ADHD (attention deficit hyperactivity disorder) and any existing allergies.
Like traditional antidepressants, St John's wort will not treat the cause of depression. In some cases, depression may arise due to naturally low levels of neurotransmitters, such as serotonin, which leaves us feeling low.
However, in many cases, depression is triggered by life events which may need to be addressed through non-drug treatments such as psychotherapy and counselling.
Despite the risks and dangers discussed, St John's wort overall has a good safety record.
St John's wort is one of the best selling herbal supplements in the world. If there was much variation or risk from the product, popularity would fall and calls for regulation would arise.
Compared to traditional antidepressants, St John's wort is a relatively safe antidepressant to take and has stood the test of time. The historical use of St John's wort dates back to more than 2000 years to the time of ancient Greece.