The celebration and application of St. John’s Wort in herbal healing goes back more than 2000 years: native to Europe, Asia and northern Africa, ancient Europeans first believed it to be a source of protection against evil and disease. Indeed, it’s Latin name, Hypericum perfortaum, reflects such belief: Hypericum comes from the Greek word “eikon,” translating into over-apparition, a reference to the idea that the smell of the flower would cause evil spirits to flee (Herbal Legacy, 2010). The plant’s common name comes from an early Christian legend claiming that the yellow, star-shaped flowers (their five yellow petals resembling a halo) bloom always on June 24th—the birthday of St. John the Baptist—and, when picked, secrete a crimson colored liquid, symbolizing the blood of the fallen saint. Christians (in a throw-back to pagan legends) would carry a sprig of the flower as a method of “spiritual protection” from sin and the devil (Nelson 2010).

More realistic applications of St. John’s Wort go back equally far in our history: there exist records of the herb’s use as far back as 400 B.C. The Greek physicians Hippocrates, Galen, and Discorides, alike, touted the herb as an effective diuretic, also helpful with healing wounds, as a treatment for menstrual pains and—most notably—as a remedy to malaria (Murder, Magic & Mystery). The Greeks and Romans also celebrated the herb’s effectiveness as a treatment for ‘melancholy,’ a sentiment echoed by one of the first documented scientific trails of St. John’s Wort, performed by Justin Kerner, a German physician in the early 19th century. Though this discovery came on the precipice of scientifically oriented medicine, St. John’s Wort would be virtually ignored as an effective psychotropic drug until the following century (Schulz et al, 1998).

Once again recognized as an effective treatment for mild depression, St. John’s Wort is taken every day as a tea, tablet, or capsule by millions of people worldwide. It’s popularity is notable particularly in Germany, with over three million prescriptions for the herb being given, popular as a coated tablet, medicinal tea infusion, a juice or tincture. Recommended dosage (worldwide) is around 300 mg of extract, three times daily, to feel any therapeutic effect. As a marketed herbal supplement, extracts are generally standardized to contain 0.3% hypericin, the herb’s most studied active ingredient (Schulz et al, 1998).

The celebration and application of St. John’s Wort in herbal healing goes back more than 2000 years: native to Europe, Asia and northern Africa, ancient Europeans first believed it to be a source of protection against evil and disease. Indeed, it’s Latin name, Hypericum perfortaum, reflects such belief: Hypericum comes from the Greek word “eikon,” translating into over-apparition, a reference to the idea that the smell of the flower would cause evil spirits to flee (Herbal Legacy, 2010). The plant’s common name comes from an early Christian legend claiming that the yellow, star-shaped flowers (their five yellow petals resembling a halo) bloom always on June 24th—the birthday of St. John the Baptist—and, when picked, secrete a crimson colored liquid, symbolizing the blood of the fallen saint. Christians (in a throw-back to pagan legends) would carry a sprig of the flower as a method of “spiritual protection” from sin and the devil (Nelson 2010).

More realistic applications of St. John’s Wort go back equally far in our history: there exist records of the herb’s use as far back as 400 B.C. The Greek physicians Hippocrates, Galen, and Discorides, alike, touted the herb as an effecctive diuretic, also helpful with healing wounds, as a treatment for menstrual pains and—most notably—as a remedy to malaria (Murder, Magic & Mystery). The Greeks and Romans also celebrated the herb’s effectiveness as a treatment for ‘melancholy,’ a sentiment echoed by one of the first documented scientific trails of St. John’s Wort, performed by Justin Kerner, a German physician in the early 19th century. Though this discovery came on the precipice of scientifically oriented medicine, St. John’s Wort would be virtually ignored as an effective psychotropic drug until the following century (Schulz et al, 1998).

Once again recognized as an effective treatment for mild depression, St. John’s Wort is taken every day as a tea, tablet, or capsule by millions of people worldwide. It’s popularity is notable particularly in Germany, with over three million prescriptions for the herb being given, popular as a coated tablet, medicinal tea infusion, a juice or tincture. Recommended dosage (worldwide) is around 300 mg of extract, three times daily, to feel any therapeutic effect. As a marketed herbal supplement, extracts are generally standardized to contain 0.3% hypericin, the herb’s most studied active ingredient (Schulz et al, 1998).

Hypericin, along with pseduohypericin, protohypericin and a host of other hypericin variants, are napthodianhtrones, found within the quinone family. These compounds are found within the dried plant in levels of about 0.1% (though standardized extracts contain concentrated levels). Research into hypericin’s biochemical activity within the brain is vast and varied, with no single theory hailed as ultimately correct. Originally, hypericin was studied as a possible monoamineoxidase inhibitor (MAOI), acting to prevent the breakdown of monoamine neurotransmitters (like serotonin and norephinephrine)—the “classical hypothesis” for the pathophysiology of depression. This theory has lost popularity in recent years as an increasing number of studies found evidence for the hypericum extract as an inhibitor of the uptake of norepinephrine and serotonin in neural synapses. At a concentration of 6.2 microgram/mL, German scientists showed that a 50% inhibition was observed in rat neurons—this level being considered a “pharmacologically active” concentration (Schultz et al, 1998).

With over 30 clinical trials performed since 1979, St. John’s Wort continues to elude easy classification as unarguably significant treatment for depression. Most European studies have shown a statistically significant improvement in the treatment of moderate to mild depression, perpetuating the herb’s popularity in that geographical area. As of late, however, two studies, performed within the U.S. and published in the Journal of the American Medical Association, have proclaimed the opposite: the clinical trials were negative, suggesting that the herb was actually ineffective. The validity of these trials have since come into heavy questioning, with claims abound that any ineffectiveness was a product of an attempt to treat severe depression, with St. John’s Wort only ever being approved as a treatment for milder forms. In response to this, a French trial was undertaken, the largest placebo-controlled trial utilizing SJW to date. Dubbed the “Lecruiber trial,” dosages were rigorously controlled at the daily recommend value of 900 mg/day (in response to the U.S. trial’s general flexibility with changing 900-1,500 mg doses depending upon response). The trial reconfirmed the efficacy of SJW as a treatment for mild to moderate depression, noting, however, that a high placebo effect was seen (Brown, 2003).

Critical to our modern appetite for SJW is the increasing amount of research regarding the herb and drug-drug interactions. Pharmacological studies that shown that SJW may reduce the efficacy of drugs used to combat HIV, as well as possibly oral birth control. Evidence for the herb effecting chemotherapeutic drugs has also been seen (ABS).

Regardless of a continually scrutinized reputation, St. John’s Wort continues to be studied and used as a treatment for forms of mild to moderate depression. It is of worthy note that 20-50% of patients on traditional pharmaceutical (tricyclic) antidepressants experience negative drug effects within the earliest stages of use, including severe side affects like sedation. While St. John’s Wort cannot boast as an undisputedly effective reputation as these synthetic alternatives, it still holds the advantage of being well tolerated by patients, with relatively few side effects. This suggests that St. John’s Wort is not only a deserving alternative, but a promising prospect in the treatment of growing levels of depression world wide (Schulz et al,  1998).

Works Cited

American Botanical Society. St. John’s Wort. Retrieved from http://cms.herbalgram.org

Brown, D. St. John’s Wort Extract Effectively Treats Mild to Moderate Depression in Large French Trial. Herbal Gram. 2003, 57, 26-28.

Nelson. History of St. John’s Wort. 2010. Retrieved from http://www.herballegacy.com/Nelson_History.html

Schulz, V., Hansel, R., Tyler, V. Rational Phytotherapy. Berlin: Springer Press, 1998. Print.