{"id":54742,"date":"2022-10-27T09:30:19","date_gmt":"2022-10-27T13:30:19","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=54742"},"modified":"2026-03-25T19:52:16","modified_gmt":"2026-03-25T23:52:16","slug":"teaching-patients-about-st-johns-wort","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/teaching-patients-about-st-johns-wort\/","title":{"rendered":"How to talk to your patients about St. John’s wort"},"content":{"rendered":"

The medical use of St. John\u2019s wort <\/span>dates back millennia<\/span><\/a>. St. John\u2019s wort, known for its bright yellow flowers, has been used for an array of different indications. In relatively recent times, however, St. John\u2019s wort has become popular as an herbal aid for depression. With over <\/span>30%<\/span><\/a> of Americans reported to be using herbal supplements, pharmacists should be aware of their potential benefits and risks.<\/span><\/p>\n

Some patients may be using St. John\u2019s wort to self-treat depression. While it may help, the potential for side effects and drug interactions should not be overlooked. For this reason, pharmacists need to talk to patients about St. John\u2019s wort, albeit in a way that is open and non-judgmental.\u00a0\u00a0<\/span><\/p>\n

RELATED: <\/b>St. John\u2019s wort coupons<\/b><\/a><\/p>\n

Understanding St. John\u2019s wort<\/span><\/h2>\n

St. John\u2019s wort, known by its scientific name hypericum perforatum, is a flowering plant <\/span>native to Europe<\/span><\/a> and parts of Asia and Africa. The active components of St. John\u2019s wort include hypericin and hyperforin.\u00a0<\/span><\/p>\n

St. John\u2019s wort is believed to work as a serotonin reuptake inhibitor. It is also believed to inhibit monoamine oxidase to increase levels of norepinephrine and dopamine. Increasing levels of these neurotransmitters may play a role in relieving depression.\u00a0<\/span><\/p>\n

The active components of St. John\u2019s wort are metabolized in the liver by the <\/span>CYP enzymes<\/span><\/a>. In addition, St. John\u2019s wort can induce the CYP3A4 enzyme, which can lead to dangerous drug interactions.<\/span><\/p>\n

The evidence behind the use of St. John\u2019s wort<\/span><\/h3>\n

The benefits of St. John\u2019s wort for treating depression are not entirely clear, <\/span>according to different studies<\/span><\/a>, and more research is needed. Several studies suggest that St. John\u2019s wort is as effective as a placebo for treating moderate to severe depression. Other studies suggest that St. John\u2019s wort may be more effective than placebo and similarly effective to certain <\/span>SSRIs<\/span><\/a> and tricyclic antidepressants for treating mild to moderate depression.\u00a0<\/span><\/p>\n

RELATED: <\/b>The best diet for depression<\/b><\/a><\/p>\n

Teaching patients about St. John\u2019s wort<\/span><\/h2>\n

Because St. John\u2019s wort is an <\/span>herbal supplement<\/span><\/a> that is not regulated by the FDA, there are some important aspects of treatment to be aware of. For example, St. John\u2019s wort preparations are not standardized and may contain different amounts of St. John\u2019s wort than what is labeled. Patients should be advised to research the manufacturer of the product they\u2019re interested in to assess quality and safety. Research-grade hypericum may be an option that delivers a more predictable dose than other products.\u00a0<\/span><\/p>\n

The dosage for St. John\u2019s wort can vary. A typical starting dosage of a product with 0.3% hypericin content is 900 mg per day. However, the dosage can range from 200 to 1,000 mg per day. It\u2019s best to find out the dosage the patient may be taking and advise them on what may be an appropriate dose.\u00a0<\/span><\/p>\n

Always encourage patients to read the labels of supplements and educate them about the possible risks and benefits. <\/span>Developing trust and rapport<\/span><\/a> with the patient is a good way to have an open conversation about the herbal medications they may be taking. That way, you can find out why they may be taking an herbal medication over a prescription drug and steer them toward the right treatment if needed. Patients may be able to get better symptom relief from other, proven medications.\u00a0<\/span><\/p>\n

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