View by: Most helpful — Most recent — Highest effectiveness

Rated St. John's Wort (Hypericum perforatum) for Obsessive Compulsive Disorder

28 of 57 people found the following helpful

Perceived effectiveness 8.0	Tolerability (higher=less side effects) 9.0
Ease of use 10.0	Would you recommend? 9.0

Comment

Good supplement! Although I am not taking it anymore, St. John's Wort worked well for me for years for Obsessive Compulsive problems, as well as for Social Anxiety. It wasnot as effective though for depression by itself. But in combination with Ginseng and Ginkgo, it worked to really elevate my mood too! For the price, and the very low risk of bothersome side effects, it is a good alternative to SSRI's, and it works more like an MAO-I or a Tricyclic in the fact that it induces motivation and energy as well as calm. I would highly recommend it for any anxiety disorder, and especially for lethargic depression as well. On the downside, the withdrawal effects are very bad once 2 weekshits!

http://www.organicconsumers.org/articles/article_12944.cfm

Check on

St. John's wort and serotonin syndrome

From AAFP article:

Adverse Effects, Contraindications, and Drug Interactions

Because of the possibility of developing serotonin syndrome, use of St. John's wort in conjunction with selective serotonin reuptake inhibitors is not recommended. St. John's wort should be used cautiously in patients with bipolar disorder because there have been a few case reports of St. John's wort-related mania.28

Table 229-40 lists the possible drug interactions that may occur with St. John's wort. The results of one report41 suggest that induction of cytochrome (CYP) P450 3A4 activity by St. John's wort may have a substantial impact on the effectiveness of pharmaceutical agents because at least one half of all marketed medications are metabolized via this pathway.

Given the induction of CYP 3A4, concurrent use of St. John's wort may reduce the effectiveness of oral contraceptives. In a study35 of 12 healthy premenopausal women who received an oral contraceptive along with 900 mg of St. John's wort daily in three divided doses, researchers noted a shorter estrogen half-life and increased breakthrough bleeding. Women using oral contraceptives should be counseled regarding possible breakthrough bleeding and might consider a barrier method of contraception when taking St. John's wort.35

Additional study is needed to establish if and how St. John's wort interacts with specific pharmaceutical agents. Experience to date suggests few clinically significant interactions. Until the results of ongoing studies on this matter have been published, the medications listed inTable 229-40 should be considered to have potential interactions and should be monitored when used concurrently with St. John's wort. Family physicians should query all patients about the use of St. John's wort and other herbal agents.

Also

Dosage

Findings suggest that 900 mg of St. John's wort (450 mg two times daily or 300 mg three times daily) is needed to reduce symptoms of depression.8,10,17 Because plasma levels continue to show a gradual rise over several weeks, the full clinical effect of St. John's wort may take two to four weeks to manifest.

St. John's wort research

From the American Academy of Family Physicians, http://www.aafp.org/afp/20051201/2249.html:

"A Cochrane Systematic Review9 used specific criteria to examine the use of St. John's wort for depression. Study limitations included heterogeneous diagnoses of depression, short trial durations, and low dosages of standard antidepressants in comparison trials. In all but one of the 27 clinical studies (n = 2,291) of different hypericum preparations, investigators concluded that St. John's wort was either more effective than placebo or as effective as older pharmaceutical antidepressants in the treatment of mild to moderate depression.

More recently, 13 additional clinical trials have been published, some of which, along with a Cochrane review, are summarized in Table 1.9-19 In 10 of these studies, investigators found that St. John's wort was superior to placebo11,16,20-22 or as effective as standard antidepressants (e.g., amitriptyline [Elavil],10 fluoxetine [Prozac],12,13 imipramine [Tofranil],11,14 sertraline [Zoloft]15) in the treatment of mild to moderate depression. Two updated meta-analyses exploring the effectiveness of St. John's wort for the treatment of depression are based on studies published between 1979 and 2003.23 Although their results suggest the possibility that St. John's wort may be less effective than previously assumed, the meta-analyses indicated that St. John's wort was significantly more effective than placebo (risk ratio for first meta-analysis: 1.97, 95% confidence interval [CI], 1.54 to 2.53; risk ratio for second meta-analysis: 1.73, 95% CI, 1.40 to 2.14).

Studies17-19 on the use of St. John's wort in patients with major depression have had conflicting results.According to the results of one double-blind, placebo-controlled, multi-center clinical trial18 (n = 200), St. John's wort was effective in treating outpatients with major depression. Although the number of patients achieving remission in symptoms of depression was significantly higher with St. John's wort therapy than with placebo (P = .02), overall remission rates were low (14.3 and 4.9 percent, respectively).

[SOME NEUTRAL REPORTS] The Hypericum Depression Trial Study Group conducted a double-blind, randomized controlled trial19 (n = 340) in 12 academic and community psychiatric research clinics in the United States. Investigators found that St. John's wort and sertraline did not differ from placebo for major depression outcomes or adverse events. The authors of an earlier study17 (n = 209) concluded that St. John's wort was equivalent to imipramine in patients with severe depression.

Taken together, the data10-22 continue to support the overall conclusions of the Cochrane review,9 as well as other published reviews,24,25 that St. John's wort is more effective than placebo and as effective as standard antidepressants for the treatment of mild to moderate depression. "

St. John's wort most prescribed antidepressnt in Germany

From the journal of the American Academy of Family Physicians, http://www.aafp.org/afp/20051201/2249.html:

"In Germany, St. John's wort is the most commonly prescribed antidepressant. In 1984, the German Commission E designated St. John's wort as an approved herb,1 and its safety and effectiveness are reevaluated periodically."

The rest of the article can be found at the link.

St. John's wort: Used since ancient times

From http://cms.herbalgram.org/herbalmedicine/StJohn27swort.html:

Many of SJW's therapeutic applications (except antiviral use), including its uses as a vulnerary, diuretic, and treatment for neuralgic conditions, stem from traditional Greek medicine, originally documented by ancient Greek medical herbalists Hippocrates (ca. 460–377 B.C.E.), Theophrastus (ca. 372–287 B.C.E.), Dioscorides (first century C.E.),and Galen (ca. 130–200 C.E.) (Bombardelli and Morazzoni, 1995; Hobbs, 1990; Leung and Foster, 1996; Upton, 1997).Since the time of Swiss physician Paracelsus (ca. 1493–1541 C.E.) it has been used to treat psychiatric disorders. At that time it was described as "arnica for the nerves" (Reuter, 1998). The aerial flowering parts of SJW have been used in traditional European medicine for centuries to treat neuralgia, anxiety, neurosis, and depression (Rasmussen, 1998). The traditional way to take SJW was as herbal tea, an aqueous extract whose single dose corresponded to 2–3 g of dried crude drug (Schulz et al., 1997). In the nineteenth and twentieth centuries, American Eclectic physicians prescribed SJW to treat hysteria and nervous affections with depression. It was prescribed externally to treat wounds, bruises, sprains, and much more (Ellingwood, 1983; Felter and Lloyd, 1983; Felter, 1985; King, 1866; Snow, 1996; Upton, 1997). Today, St. John's wort is official in the national pharmacopeias ofCzechoslovakia, France, Poland, Romania, and Russia (Bruneton, 1995; Hobbs, 1989; Newall et al., 1996;Ph.Fr.X, 1990; Reynolds, 1993; Upton, 1997; USSR X, 1973).

St. John's wort: Few side effects

From http://cms.herbalgram.org/herbalmedicine/StJohn27swort.html:

"Studies that compare treatment with SJW to treatment with a synthetic antidepressant have not lasted longer than six weeks and have been compared using about one-half the usual dose of the antidepressant (75 mg imipramine instead of 150 mg). In addition, they have not been conducted with severely depressed patients. Yet SJW has been shown to be safe, with very few side effects, compared with synthetic antidepressants: out of 3,250 patients, only allergic reactions (0.5%), gastrointestinal upset (0.6%), and fatigue (0.4%) were observed (De Smet and Nolen, 1996). Evidence of the antidepressant activity of SJW extracts can be found in reviews by Bombardelli and Morazzoni (1995), Linde et al. (1996), and Upton (1997). No significant modern human studies investigating SJW's other therapeutic uses have been found (e.g., orally for dyspeptic complaints and topically for burns, lesions, wounds, and myalgia)."