Evidence brief · Supplement

St. John's Wort for Mild-to-moderate depression

Evidence grade B — Cochrane: ~ as effective as SSRIs

Overall grade
Grade B
Last revised
1
graded outcome
0
references listed

Assembled by the app from other entries in this library. It adds no evidence of its own — follow the links to the entries it draws on.

1 at grade B — 1 graded row

What is known

Each outcome with its grade (how strong the evidence is, A to D), the size of the effect where the entry records one, and how often studies agree.

  • Mild-to-moderate depressionEvidence grade B

    Cochrane: ~ as effective as SSRIs

    Moderatehigh

The evidence in words

The verdict

For mild-to-moderate depression, St. John's Wort earns evidence grade B (moderate effect, high consistency) — there is real evidence here. Cochrane: ~ as effective as SSRIs

How it might work

It inhibits reuptake of serotonin, norepinephrine, and dopamine (an SSRI-like action) — and, critically, hyperforin potently induces the CYP3A4 enzyme and P-glycoprotein transporter, accelerating the breakdown of a huge range of medications.

How to use it

300 mg of a standardized extract three times daily is the trial dose — but only after auditing every medication you take with a pharmacist. It is not a casual add-on.

Safety & cautions

The efficacy is real; the danger is interactions. Photosensitivity can occur. Never combine with SSRIs/SNRIs, and treat it as capable of neutralizing many prescriptions.

Bottom line

Effective for mild-to-moderate depression, and the supplement most likely to sabotage your other medications. Only under professional guidance with a full drug review — never alongside antidepressants or the pill.

How it is used

As the entry records it, from the studies it summarises. Not a recommendation for you — doses that suit a trial population may not suit you.

Trial dose
300 mg standardized ×3/day — audit all meds first.

Goes with

Entries that share this one's tags or conditions.

Sources

This entry lists no references of its own — it is assembled from the entries it links to, whose sources are on their pages.

Last revised . A grade is this entry's reading of the evidence, not medical advice.