St. John's Wort: Health Benefits, Side Effects, Uses, Dosage, Warnings?


St. John's Wort: Benefits, Side Effects, Uses, Dosage, Warnings?

St. John's Wort or Hypericum perforatum, is a plant that can be anywhere in Europe, and now beyond, encounter. It grows on dry, but nutrient-rich sites and you'll find him along the rail, road, meadows and into the bushes. It is a perennial plant of the St. John's-wort family (Hypericaceae). The herb blooms with yellow flowers from June to September and harvesting begins when the sun is at its highest, around the St. John's Festival on June 24. For centuries, the plant is used as a medicinal herb and as a natural antidepressant.
What is it?
St. John's Wort can be used for different purposes. As said St. John's Wort contains a natural antidepressant and can really help you if at all does not worry and you feel lethargic and depressed. Do you suffer from gloomy moods then John's Wort tablets have the sharp edges and help you pick through your dip it. The herb provides guidance during difficult periods by peace, optimism and new courage. This is because it is equipped with fabrics that have a strengthening and calming effect on the nervous system. It helps against various symptoms of stress, such as palpitations, hyperventilation, bedwetting, headaches, insomnia and even stuttering.

There are tablets to get St. John's Wort, but it is also available as oil, tincture or cream. The oil is dark red in color and is very helpful for burns, sunburn or chilblains. Furthermore, you can also use it as a massage oil for muscle and joint pain, as it has a warming effect and stimulates circulation.

In addition, it is a disinfectant and can be as tincture applied to a wound or as drops in the ear with ear pain.

It also has a calming effect on eczema. But do not use St. John's wort oil form before you go into the sun, as it is photosensitive.

Active substances in Hypericum perforatum
For the proper functioning of the body (and mind!) Information must be transmitted between nerve cells in the brains. This transfer takes place by means of the so-called neurotransmitters. A disruption of certain neurotransmitters can result in depression and probably vice versa.

In St. John's Wort different substances that have an antidepressant effect. Sit The most important are the hypericinen fall below hypericin, pseudo hypericin and hyperforin. These are psychoactive substances that uplifting work by the reuptake of the neurotransmitters serotonin, among others, norepinephrine and dopamine inhibit while also goes reuptake of L-glutamate and GABAD against. If you take St. John Spice, finally comes around 20% of hypericin after 1 to 2 hours in your bloodstream. It remains more than 24 hours in the circulation present.

A mixture of these three substances helps to prevent well. Mild depression Do not contain all St. John's Wort Tablets all three substances. It is even so that the composition of a variety of St. John's wort compositions can vary greatly. Sometimes the only contains hypericin, but also that often works adequately. Still, it is advisable to compare the different brands.

Dosage and duration
The St. John's Wort can best be dosed depends a bit on your complaints. To do this, we focus on the guidelines contained in the package insert or the jar. How long should you keep taking the tablets depends again on your complaints. Usually, it is recommended not to swallow after your symptoms have disappeared for a while. This is in order to prevent a relapse.

When St. John's wort begins to work?
If you're going to really impact brands depends on the severity of your symptoms and the composition of the extract. Usually you start after a week or two to notice the first effects, and after 4 to 6 weeks you will see really significant improvement of symptoms. Basically you need to use St. John's Wort Tablets not to build, but if you are afraid of a relapse, it may be for your own self-confidence is better to gradually diminish.

What does this medication and where is it used?
St. John's wort has an antidepressant effect.
Like other medicines for depression St. John's Wort affects the body chemicals in the brains that play a role in moods and emotions. How it works is not fully understood.
Caution! Only with the medications that are registered as drug efficacy has been studied. The herbal products containing St. John's wort (see also the section "How to obtain funds necessary prescription and what dosage bottom of this text). St. John's wort is used in depression .


With depression, there is a somber mood, no more interest and pleasure in the things of life. Someone who is depressed often feel worthless and guilt. Also, depressed people may be irritable and have trouble falling or staying asleep.
Depressive symptoms can be treated with psychotherapy (calls), with medications, or with a combination of both. Your doctor will decide which treatment is best for you is with you. It then depends on your personal situation and the type of depression, with which medication the doctor will start.
People with mild to moderate depression found by St. John's wort to feel more energetic and find that it improves their mood.
may take you notice the positive effect of St. John's wort. four to six weeks The first few weeks you can still suffer from the side effects. Do not stop taking it, usually reduce the side effects if you are accustomed to the drug. Often they even disappear.

For more information about drugs in depression .

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In addition to the desired effect, this medication can cause side effects.
Side effects do not occur at all, but only in persons who are therefore sensitive.
Many side effects are in the first week and then most pronounced decrease or even disappear. They go back on when you stop the drug.
The main side effects are the following.
Very rare
Fatigue .
Gastrointestinal complaints such as nausea and diarrhea. This is usually within a few days, if you are accustomed to the drug. You have less experience these side effects if you take it with some food. Also you remain there after a few days of intrusive? Talk to your doctor.
Dry mouth , because you are creating less saliva. This may lead to earlier holes develop in your teeth. Brush and floss therefore take extra care if you find that you suffer from dry mouth. Please leave the dentist more frequent monitoring.
Dizziness , confusion, restlessness and headaches.
Temporary sexual dysfunction such as decreased interest in sex, hard erection and delayed ejaculation. These side effects go on when you stop the drug. Contact your doctor if you experience here.
Hypersensitivity to this medication. You may get a rash or itching. Rarely creates hypersensitivity to sunlight or UV light from a tanning bed. Discontinue use and consult your doctor. With allergies, you may not use St. John's wort in the future. Give to the pharmacist by that you are allergic to St. John's wort. The pharmacy team can then make sure that you do not get this medicine again. Note especially yourself if you buy drugs without a prescription.
Consult your doctor if you have too much experience any of the above events, or if you experience any other side effects you are worried about.

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How should I use this medicine?

»Instruction: Administer tablets and capsules

Look for the correct dosage on the label of the pharmacy or in the package insert. When?

If you are this medicine 1 time a day use: prefer morning after taking breakfast.
If you are this medication three times a day used as a good divide your intake over the day. It is best to choose fixed intervals to keep. Chance to forget as much as possible
How long?
After 4 to 6 weeks, you can expect an improvement in mood. Do you notice after that period too little effect then continued use probably no sense.

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What should I do if I forget a dose?
If your doctor has prescribed this medication, it is important to consistently use. Only then can you and your doctor assess the effect well. Should you have missed a dose:
You use this medicine 1 time a day : it takes more than 8 hours before the next dose taking normal? Take the missed dose downhill. It takes less than 8 hours? Skip the missed dose.
You use this medication three times a day : it takes more than 2 hours before the next dose taking normal? Take the missed dose downhill. It takes less than 2 hours? Skip the missed dose.

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If I use this medicine, may I ...
Usually, this drug has no effect on driving ability. Driving then no problem. But it may be that if you use this medicine, some tired, dizzy or confused. Do you have this problem? Then you should not drive. Caution: depression also may be a reason that you should not drive. Talk to your doctor if this is the case for you. Want more information about driving in certain conditions? Please check the website of the CBR . For more general information, the theme ' Medicine in traffic reading. " In this theme, for example, you can read what the law says about drugs in traffic. You will also find advice that you should consider when you can drive. (Again) drink alcohol and eat everything? There are no restrictions for this drug are known.

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Does this medication interact with other medications?
This drug has interactions with other medications. In the text below, only the active ingredients of these drugs, not the brand names. Whether your medicine contains any of those active substances, you can check in your leaflet under 'composition'. Medications that the key interactions occur, are the following.

St. John's wort reduces the effect of these medicines. Therefore always tell your doctor and pharmacist that you are taking St. John's wort.
Talk to your doctor or pharmacist before using this combination. Your doctor will prescribe a different medication, increase the dose to control the amount of this medication in your blood or advise you to stop taking St. John's wort.
Even if you stop taking St. John's wort, you should consult with your doctor. Sometimes, the dosage of the drugs listed below must then be adjusted again.
Contraceptive pill . St. John's wort decreases the reliability of the pill, thereby increasing the chances of a pregnancy. For short-term use : g se condoms during and up to four weeks after stopping St. John's wort to ensure that reliable contraception is used. With prolonged use: you can use St. John's wort only in combination with an oral contraceptive with a high dose of hormones, called a 50-pill. If you get breakthrough bleeding in the first three months of use, you must assume that St. John's wort also affects the reliability of the heavier 50-pill. The doctor may recommend you use consecutive week without stop, multiple strips or shortening the gap week to four days to reduce. The chance of a low amount of hormone Be sure to use condoms as long as breakthrough bleeding occurs.
If you stop taking St. John's wort, the effect on the hormones still for four weeks. So you can not immediately switch to a lighter pill, but you must take extra steps four weeks after stopping.
Note : also the only progestin-containing drugs such as the mini pill with desogestrel and implantation rod by St. John's wort less reliable. This also applies to the vaginal ring and the pilpleister . Talk to your doctor or pharmacist.
St. John's wort also reduces the effect of these medicines.
The sleeping and calming medications alprazolam, midazolam and buspirone.
Atorvastatin and simvastatin , cholesterol-lowering drugs.
The anticoagulant drug warfarin and phenprocoumon . Indicate the thrombosis by when you start or stop taking St. John's wort.
The heart drug digoxin .
Quinidine , a medicine to control heart rhythm. By concomitant use of St. John's wort cardiac symptoms can be worse again.
Ivabradine, a drug for chest pain.
Theophylline , a bronchodilator. This could increase. Symptoms of distress
Cyclosporine , tacrolimus and sirolimus . These are immunosuppressive drugs. Your doctor will increase the dose of this.
The drugs against HIV azatanavir, darunavir, efavirenz, etravirine, fosamprenavir, indinavir, lopinavir with ritonavir, maraviroc, nelfinavir, nevirapine, rilpivirine, ritonavir, saquinavir and tipranavir. You may not use these medications with St. John's wort.
The drugs for hepatitis C, telaprevir and boceprevir. You also may not use St. John's wort with this medicine.
Imatinib, a drug used in cancer.
Voriconazole , an antifungal drug. Do not use St. John's wort if voriconazole is used.
If you are unsure as to whether any of these interactions is important for you? Please contact your pharmacist or doctor. Always tell your doctor that you are taking St. John's wort.

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Can I use this medication if I am pregnant, wants to be or breastfeeding?
use this medication only after consultation with your doctor. When using this medication during pregnancy, the child may experience withdrawal symptoms after birth. Moreover, there are not many pregnant women who have used this drug. Therefore, it is not sure what the risks for pregnant women and their children. But depression can also be harmful to the mother and the child. Therefore, consult with your doctor about the pros and cons.
You get this medication for the first time and want to become pregnant or are you pregnant? Talk to your doctor before starting this medication. You may experience better start right away with another drug. For example, a drug out of the group of serotonin reuptake inhibitors (SSRI's), such as fluoxetine. Or a tricyclic antidepressant (TCA), such as amitriptyline. With the drugs from these groups is in fact more experience when used during pregnancy.
You are taking this medicine for and want to get pregnant? Talk to your doctor first. Maybe you should switch to another drug. For example, a drug out of the group of serotonin reuptake inhibitors (SSRI's), such as fluoxetine. Or a tricyclic antidepressant (TCA), such as amitriptyline. With the drugs from these groups is in fact more experience when used during pregnancy.
You are taking this medicine and become all you pregnant? Talk to your doctor straight away. Stopping this medication or change is usually not recommended. To another drug Return of the depression can be harmful to the mother and the child. You and your doctor can discuss the risks for you and the baby if you continue with the drug.
Would you breastfeed, talk to your doctor. This drug comes in a small amount in breast milk. It is not known whether this is harmful for the baby. Maybe the doctor can prescribe a drug from SSRIs or TCA group. With the drugs from these groups is in fact more experience when used during breastfeeding.

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Can I just stop taking this medicine?
You can stop at once with the use of St. John's wort. Do you have more than the usual dose used for several weeks, it is wise to build over a period of a few days to weeks. Ask your doctor or pharmacist for advice.
After abrupt discontinuation of high doses, some people may experience gastrointestinal discomfort, dizziness, dry mouth, thirst, chills and fatigue.
Not everyone has as much experience withdrawal symptoms. If you do not suffer from, you can stop at once.

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Recipe needed and what dosage?
Some drugs with St. John's wort are registered with the government as an official medicine. These have since 2008 on the market and are only available in pharmacies without a prescription. They are available under the brand names Hyperiplant Laif and 900 mg tablets.
If you suffer from depression and hypericum want to buy in the pharmacy, you get this advice from the pharmacist. To be able to give good advice, the pharmacist is required. Information about your symptoms and other medical information from you On this basis, your pharmacist can advise you and also check whether St. John's wort goes along with your other medications.
Other drugs with St John's wort are herbal remedies and having to contain and efficacy has not been studied. not a constant amount of active ingredient You must take into account the same side effects and interactions as in the registered drug.
Herbal remedies containing St. John's wort are internationally since 1996 on the market and available as an extract or dried herb, in capsules, dragees, tablets, drops and herbal teas. St. John's wort is a part of include:

Arkocaps St. John's Wort capsules
Best Choice St John's wort capsules
Beturca drops
Hypericum perforatum Bonusan drops
Hyperiforce forte tablet
Kira Kira forte caplet 300 mg and 450 mg tablet
Kneipp St John's Wort
Laif tablet 600 mg
Nervoregin tablet
New Care St John's wort capsule
Now St John's wort extract vcaps
Optimax Super St. John's Wort tablet
Orthica Hypericum capsule
Phytocaps St. John's Wort
Salus St. John's Wort
St. John's Wort capsule
St. John's Wort Pigge
Springfield St. John's Wort
Vitortho St John's root extract capsule
Vitotaal St. John's wort capsule
Vogel Hyperisan

Want to know more about the price and compensation for your medication, please continue with the theme of pricing and reimbursement of medicines . Click here for more information about: Hypericum , Hyperiplant , Laif 900 mg

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Personal advice
Want to know more, or you have a question about your own situation? Pay a visit to your local pharmacy. Your pharmacist is aware of your personal circumstances and can guide you expanded your medication.

The St. John's wort ( Hypericum perforatum ) is a plant of the St. John's-wort family ( Hypericaceae ). The perennial plant is native native to Europe, but has spread from there. The herb blooms around St. John's Festival on June 24, the time when the sun is at its highest, with yellow flowers which then also be harvested.

The species has long been used as a medicinal herb and as a vegetable antidepressant available.

Contents [ hide ]
1 Description
2 Use
2.1 Medical use
2.2 Adverse reactions
2.2.1 Interactions with drugs
2.3 Medical use in antiquity
2.4 St. John's wort as a repellent
3 External link
Description [ edit ]
The plant is 20-85 cm tall and has a round stem with two small tables. The barren, elliptic or ovate, entire-margined, 1.5-3 cm long leaves have numerous translucent dots and a blunt blade foot . The transparent dots are filled with essential oil .

St. John's wort flowers from June to September with yellow flowers . The petals are 1-1.6 cm long. The sepals are lanceolate, pointed and smooth edge. The petals have little black dots. The inflorescence is a corymb .

The fruit is a capsule with only long, glandular stripes (vittae).

The plant is found in dry, grassy, ​​nutrient-rich places along roads, railways and bushes.

Use [ edit ]
Esculaap Take the reservation on medical information into account.
Consult with a health physician .
Medical use [ edit ]
Different substances in St. John's wort may be responsible for the attributed to phytotherapeutic preparations of this plant antidepressant effects. The hypericinen be considered in the plant, as the main psychoactive substances, in particular, this concerns hypericin , pseudo hypericin and hyperforin . Most scientific studies of Hypericum are equipped with a 0.3% hypericin standardized extract, referred to in the medical literature as "LI 160". A number of standardized hypericum products on the market are modeled on this example and are also standardized to 0.3% hypericin.

The composition of the various St. John's wort preparations varies greatly. Some only contain hypericin, but still prove effective. [1] inhibits St. John's wort, just like conventional antidepressants , the neuronal reuptake of serotonin , norepinephrine and dopamine . It also inhibits the re-uptake of GABA and L-glutamate . [2] About 20% of the hypericin is absorbed and comes after 1 to 2 hours in the blood stream. Hypericin has a relatively long half-life and continues to more than 24 hours in the blood stream.

An initial study conducted in people with major depression showed no effect of St. John's wort, possibly because this study was too small in scope. [3] A later, larger study, including those with milder depression were studied, showed like a effect seen. [4] In moderate to severe depression is fact or proof of efficacy. [5] [6]

Several smaller studies suggest that St. John's wort is effective in the treatment of mild to moderate depression than placebo and as effective as tricyclic antidepressants . This conclusion is supported by several meta-analyzes and a Cochrane review [7] of various studies. Comparisons with selective serotonin reuptake inhibitors (SSRIs) show no consistent picture, which can be about the effectiveness of St. John's wort compared with this group of antidepressants there. draw any conclusions

St. John's wort is also used as a remedy for stress and insomnia , although there are also indications that it - like some conventional antidepressants - can cause sleeplessness. Depression is often associated with insomnia, which is why it can alleviate insomnia in these cases. In primary insomnia (ie not as a result of depression) may therefore be counterproductive. In the form of St. John's Oil can be used for burns and sunburn.

The Dutch Medicines Evaluation Board (MEB) in 2007, a composition of St. John's wort (brand name Hyperiplant) registered as a medicine for mild or moderate depression. [8] According to the MEB, the applicant (VSM Medicines) the operation of the product adequately demonstrated. The MEB believes that patient safety is improved by registration as possible side effects and interactions will be noticed. Faster in the geneesmiddelenbewakingsssysteem

Leaves with oil glands
Adverse [ edit ]
St. John's wort preparations are generally well tolerated.

Possible side effects:

gastrointestinal symptoms
Skin changes (including color)
Dry mouth
Phototoxic effect. Under the influence of UV radiation from the sun or tanning bed can cause skin rashes and redness.
In the Dutch Journal of Medicine has reported a case of a patient with suicidal ideation and aggression that may be related to the use of St. John's wort. [9]

Interactions with drugs [ edit ]
St. John's wort can affect the action of drugs. Increasing the activity of the liver enzyme system cytochrome P450 , [10] [11] causes some medicines be broken down faster and has a smaller effect. Thus, including the operation of the use of St. John's wort contraceptive decrease. [12]

Observed that St. John's wort can reduce health operation of the following medications: [13]

inhibitors of the immune system, for example in organ transplants and autoimmune diseases : cyclosporine . This may result in people who have had a heart transplant to St. John's wort rejection reactions. [14]
anticoagulants of coumarinetypetype as warfarin (eg warfarin) and phenprocoumon (Marcumar);
anticonvulsants : phenobarbital and phenytoin ;
bronchodilators : theophylline ;
cardiac glycosides in heart failure and cardiac arrhythmias : digoxin ;
inhibitors of the HIV : indinavir ;
Antacids : omeprazole . [15] [16]
St. John's wort can increase the effects of antidepressants influence. This also applies if a tricyclic antidepressant such as amitriptyline , with neuropathy being used. St. John's Wort increases, many antidepressants such as, the amount of serotonin in the brains. In combination with an MAOI , an SSRI or clomipramine , there is this chance of the emergence of serotonin syndrome . [17]

Concomitant use of St. John's wort and an antidepressant is not recommended. For this reason, it is mandatory on the package or since November 2001 leaflet products containing St. John's wort to mention, warning of the effects of medication. text

Medical use in antiquity [ edit ]
In ancient times, St. John's wort has been used for burns and other wounds. [18] Hippocrates and Paracelsus have described this use.

St. John's Wort is in all European culture is an important plant, there are many legends attached to the plant, and in some cases it was even a cult plant. The herb is named for Saint John, since the peak of the bloom falls on the feast day of St. John (June 24), is also St. John of the Holy Light, his feast falls in the period of ancient Midsummer Feast , remember that St. John's fires. The red oil that the plant contains has led to many legend formation, by the old Germans would the blood have been Baldur , the Germanic God of Nature, Summer, and the light, but also the blood of Wotan after by he boar was injured. At the herb kinds of magical powers were ascribed, for example the one tied on roofs to protect against storm, there were also fertility rituals associated with the herb, for example, a woman who wanted to pick the herb was naked. Midsummer on children

St. John's wort as a repellent [ edit ]
Nicknamed " chase the devil "indicates that St. John's wort according to tradition once called as a defense herb was used to protect against witchcraft , magic , or other potential hazards.

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