special subjects
St. John’s Wort
Evidence
Numerous randomized, placebo-controlled studies have evaluated safety and efficacy of SJW in treating mild-to-moderate depression and, recently, major depressive disorders ( References ). SJW has also been compared with tricyclic antidepressants (amitryptiline, Overall, some studies show efficacy of SJW in treating mild depression, whereas in major depression most studies do not show efficacy. Differences in study design (lack of active control and placebo), study populations (major vs mild/moderate depression), length of time, and dosing of SJW or comparator agents are likely responsible for some variance in results. A 2016 systematic review of 35 studies (6993 subjects) compared SJW to placebo or conventional antidepressants ( References ). SJW was superior to placebo but not different than conventional antidepressants for mild-to-moderate depression. However studies were heterogenous and severe depression was not studied ( Two very small pilot studies show potential topical application relief from skin disorders, including psoriasis ( References ). A small trial showed SJW (standardized to hypericin but not hyperforin) did not relieve symptoms of attention-deficit/hyperactivity disorder (ADHD) in children ( 