Evidence brief · Supplement
St. John's Wort for Severe depression
Evidence grade C — Less clear
- Overall grade
- Grade C
- 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 C — 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.
- Severe depressionEvidence grade C
Less clear
Unclearlow
What is uncertain
Read off the same rows as above. Nothing here is added that the entry does not itself record.
- Thin evidence: Severe depression (grade C).
The evidence in words
The verdict
For severe depression, St. John's Wort earns evidence grade C (unclear effect, low consistency) — the evidence is limited or mixed. Less clear
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
- St. John's WortRead the full St. John's Wort monographEvidence grade B
Related reading
Entries that share this one's tags or conditions.
- St. John's Wort for Depression (mild-moderate)Evidence grade B — Under guidance onlyEvidence grade B
- St. John's Wort for Mild-to-moderate depressionEvidence grade B — Cochrane: ~ as effective as SSRIsEvidence grade B
- St. John's Wort: dosage and how to take it300 mg standardized ×3/day — audit all meds first.Evidence grade B
- St. John's Wort: side effects, safety & interactionsThe efficacy is real; the danger is interactions. Photosensitivity can occur. Never combine with SSRIs/SNRIs, and treat Evidence grade B
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.