St. John’s Wort has been used for centuries to improve mood and overall well-being, but its categorization as a nootropic has opened the possibilities for its therapeutic applications for mental health conditions like depression.
With so many pharmaceuticals with uncomfortable or even dangerous side effects out there, there is no wonder that people are looking for more natural alternatives for their health conditions.
As we become more aware of the importance of mental health, and of how common mental health conditions, like depression, really are, researchers are looking at the best ways to treat them and their symptoms.
One of the herbs historically used within different traditional medicine systems to improve mood and overall well-being is St. John’s Wort. Scientists are now looking into the application of St. John’s Wort as a nootropic substance for the treatment of serious brain conditions like depression.
If you are interested in knowing whether St. John’s Wort is effective as a treatment for depression and other conditions, please read on. In this article, we will give you a summary of what the research says regarding the effectiveness of St. John’s Wort for treating depression and boosting cognitive health in general.
Before we get into the research, however, let’s make sure we are all on the same page regarding the concepts of nootropics and depression.
A Short Introduction to Natural Nootropics
In case you are new to the world of nootropics, here’s a rundown on what they are:
Nootropics are substances, natural and created in the lab, that can boost brain function and cognition. They can be used for therapeutic purposes, such as treating the symptoms of illnesses that affect the brain or simply to improve overall learning, focus, concentration, mental agility, and others.
Nootropics, coined and described by Dr Corneliu E. Giurgea are efficient in helping to restore deficient higher nervous system activity by:
- Supporting the brain in absorbing and retaining new information.
- Helping brain cells resist components that could impair brain health.
- Promoting communication between different parts of the brain.
- Providing the components that allow for greater control over parts of the brain linked to higher brain functions.
Natural nootropics can either be naturally derived supplements, which are nootropic substances extracted from foods, herbs, botanicals, plants, and animals. Taking a naturally derived supplement is often different from consuming the whole food since it usually contains a greater concentration of the active nootropic component per weight than the food or herb.
In the case of treating mental health conditions like depression with a nootropic herb like St. John’s Wort, it is usually taken as a capsule or tablet, though it can also be found in oil and tea form.
If you want to learn more about this topic, you can access the definitive introduction to natural nootropics by clicking here.
How Depression Feels
If you or someone you know has ever suffered from clinical depression or anxiety, you are familiar with the feeling of deep sadness, loneliness, and hopelessness that can lead to a loss of interest in activities that used to excite you. Depression can also manifest itself physically through pain, hunger or loss of appetite, and insomnia, among others.
Note that while there can be some common symptoms, everyone may experience depression a little differently, and it can impact peoples’ lives differently as well.
There are several different approaches to treating depression. Your doctor or psychiatrist will work with you to identify the most appropriate options for you, but they may include:
- Psychoeducation and support groups
- Brain stimulation therapies
- Complementary and Alternative Medicine (including John’s Wort)
For people with Major Depressive Disorder (MDD), it is very hard to treat. According to research, 2/3 patients do not achieve remission after one course of treatment and one out of three fail to remit after four treatments. This reality has led researchers and doctors to push for alternative and complimentary hard research-based treatments.
Important: If you think you might be experiencing depression or have considered hurting yourself, know you are not alone and that there are people ready to help you. You can TEXT or CALL a trained professional now. Seek help from a healthcare provider. DON’T try to treat depression on your own.
If you think someone you know might be experiencing this, please reach out to them and let them know you are there to support them.
What is St. John’s Wort?
St. John’s Wort (Hypericum perforatum) is a shrub that grows yellow flowers. It is native to several parts of the world, including Europe, parts of Asia and Africa, and the western part of the United States.
In the west, the plant got its name because it is usually in full bloom on June 24th, which is the day often celebrated as St. John the Baptists birthday. The center part of the flowers protrudes, and the stamens are long, which make it look somewhat like a wort.
Both the flowers and the leaves have been used for medicinal purposes in different cultures around the world.
The identified active components of St. John’s Wort are hypericin and hyperforin, and they are found in the leaves and in the flowers of the plant. Some likely other antioxidants and oils also have a role in St. John’s Wort’s healing properties.
Note that, in the US, St. John’s Wort is categorized as a dietary supplement (just like all herbal remedies) by the Food and Drug Administration. This means that it is not regulated or scrutinized in the same way that pharmaceutical drugs are.
The Use of St. John’s Wort in History
St. John’s Wort has a long history of use in the West. It was administered by a military doctor, Proscurides, in Rome in about the 1st century AD. During this time, it was also recommended by Greek physicians Galen, Dioscorides, Pliny and Hippocrates to treat constipation, menstrual disorders, snakebites, and intestinal infections.
Leading up to and during the middle ages, people attributed magical properties to the herb. It was used as an ingredient in magic potions that was meant to ward off witches, demons and evil diseases.
The use of St. John’s Wort did not fade over time. During the 16th century, herbalist healers Paracelsus, Gerard, and Culpeper recommended St. John’s Wort to alleviate pain and to heal wounds.
Over the next several centuries, its use spread throughout Europe and other continents and was prepared in teas and tinctures to treat a range of illnesses, including anxiety, depression, insomnia, edema (water retention), gastritis, hemorrhoids, and inflammation.
St. John’s Wort for Depression: What Does the Research Say?
Today, the most common use of St. John’s Wort is for the treatment, either alone or as complementary to another treatment, of depression. In fact, several pharmaceutical companies now make pharmaceutical-grade St. John’s Wort that is commercially available.
Typical doses of St. John’s Wort range between 300-900 mg per day, depending on the company that produces the capsules. The European Scientific Cooperative on Phytotherapy monographs recommended a standard dose of 900mg of standardized St. John’s Wort extract per day for the treatment of depression. Most research has been conducted with doses that range between 300-1800mg/day.
Below, we’ll review three systematic reviews (studies that examine the overall effectiveness of several published pieces of research) that look at the effectiveness of nootropic St. John’s Wort for the treatment of depression.
The first study reviewed 29 studies that included a total of 5,489 patients with depression. The studies compared treatment with St. John’s Wort extracts with placebo treatment or standard antidepressant treatment for a period of 4-12 weeks.
The results of the first study were:
- John’s Wort extracts were superior to placebos
- John’s Wort extracts were similarly effective as standard antidepressants
- John’s Wort extracts had fewer side effects than standard antidepressants.
The second systematic review examined 35 studies, which included 6993 patients with depression. Even with a variety of different concentrations of the active ingredients hypericum and hypericin, the results showed that St. John’s Wort is an effective treatment for mild and moderate depression when compared to placebo. In these studies, St. John’s Wort was used individually, not in conjunction with another treatment.
The third review, published in 2017 took 27 clinical trials that included 3808 clinical trials into account. The results were as follows:
Compared to standard treatment for depression, St. John’s Wort:
- Had a comparable response and remission rate
- A lower discontinuation or dropout rate
- Was effective in alleviating depressive symptoms in patients
Other Health Uses and Benefits of St. John’s Wort
As you read in the section about the historical uses of St. John’s Wort, many of the treatments were related to fighting infections and healing wounds. Doctors of the time were not incorrect in observing the positive effects of St. John’s Wort for treating these conditions.
In fact, several of the conditions, besides depression, for which St. John’s Wort is used include:
- Healing wounds, including sores, bruises, burns, and hemorrhoids.
- Treating Seasonal Affective Disorder (SAD), though evidence up to now is weak.
- Treating the symptoms of menopause.
- Improvements of symptoms of obsessive-compulsive disorder.
- Quitting Smoking, but evidence as of now is very weak for this use.
- Inhibiting the spread of cancer. However, it interacts with other cancer treatments, which is why it is not recommended as a cancer treatment, despite its antitumor effects.
These uses are attributed to three main effects of St. John’s Wort: it’s antimicrobial, antiviral, and antioxidant activity.
The active ingredient hyperforin is effective against several bacteria. These include:
- Staphylococcus aureus
- Streptococcus pyogenes
- Corynebacterium diphtheriae
Hyperforin has even shown to be effective against certain multi-drug-resistant bacteria of the S. aureus strain.
This is one of the reasons why the topical use of St. John’s Wort-infused creams and ointments are effective against wounds.
Several studies report the antiviral activity of St. John’s Wort.
Components of St. John’s Wort that contain flavonoids and catechins (types of antioxidants) are effective against the influenza virus.
The active components hypericin and pseudo-hypericin may also inhibit herpes simplex virus 1 and 2 and potentially even human immunodeficiency virus (HIV). Hypericin may also actively fight against two viruses called murine cytomegalovirus and sindbid virus.
Lab studies have identified the significant antioxidant activity of St. John’s Wort thanks to its flavonoids and phenolic acids. These components have the power to fight free radicals, which can cause cell and tissue damage.
The antioxidant activity would explain the antitumor effects of St. John’s Wort. It would also be another mechanism of action through with brain health is protected and promoted, further highlighting its nootropic activity.
How Does St. John’s Wort Work?
While St. John’s Wort is effective against depression in clinical trials, the mechanism of action is not clearly understood. Originally, it was believed St. John’s Wort can counteract the effects of depression through the active component hypericin.
Hypericin acts to modulate the dopamine receptors in the brain. However, now we know that the other active component, hyperforin, is one of the major components responsible for its anti-depressive activity.
What do brain chemicals have to do with depression?
When a person has depression, there are many changes regarding the production and uptake of several key brain chemicals. One of those is dopamine, and the other is serotonin.
Effects of St. John’s Wort on the Dopamine System
The dopamine system in the brain is deficient and not properly regulated. As with many other psychiatric disorders, in people with depression, there is a deficiency of dopamine uptake in the brain.
Problems with the dopamine system can lead to anhedonia, one of the hallmark symptoms of depression, and one of the hardest to treat. Anhedonia is the inability to feel pleasure or interest, and it is also linked to a lack of motivation.
Effects of St. John’s Wort on the Serotonin System and Adrenergic System
St. John’s wort interacts with several brain chemical receptors (like those for the uptake of adenosine, GABAa, GABAb, and glutamate). Through interacting with these receptors, St. John’s Wort can lead to an increase in the regulation of serotonin receptors.
At the same time, St. John’s Wort reduces the sensitivity of the brain to beta-adrenaline by reducing the sensitivity of beta-adrenergic receptors, which can aggravate depressive symptoms.
The National Center for Complementary and Integrative Medicine reports on the safety and side effects of the use of St. John’s Wort for Depression, which we summarize below.
There are rare but serious reports of side effects of people taking St. John’s Wort who have bipolar disorder, anxiety, and schizophrenia, including worsening of psychotic symptoms. This is because the biochemistry of these illnesses is different from that of depressive disorder.
Other side effects of taking St. John’s Wort for depression are minor and rare. These may include:
- Upset stomach
- Dry mouth
- Sexual dysfunction
St. John’s Wort should not be combined with certain antidepressants, as they can have a compounding effect. One of the most life-threating effects of these interactions could be a life-threatening increase in serotonin levels.
Some symptoms of a dangerous serotonin increase include diarrhea, agitation, fast heartbeat, high blood pressure, hallucinations, fever, and others.
St. John’s Wort may also interact with:
- Birth control pills
- Cyclosporine used to prevent the body from rejecting transplanted organs
- Digoxin, a medication used for heart conditions
- Oxycodone, a pain medicine
- Some HIV drugs, including indinavir
- Some cancer medications, including irinotecan
- Warfarin, a blood thinner
Bottom Line: Is It Safe?
The use of St. John’s Wort for treating depression could be justified, but this should always be done with the guidance of a health professional. Never try to self-medicate when you have a serious condition such as depression.
Remember that St. John’s Wort is a supplement and is not regulated by the FDA like pharmaceuticals are, so the supplements available on the market vary to a great extent.
St. John’s Wort is one of the most studied botanical nootropics, and as a result, there is a wide range of evidence regarding its effectiveness for treating depression. The mechanisms of action are still being studied, but it seems to work similarly as pharmaceuticals without having many of the same side effects.
Even though St. John’s Wort it is not regulated as pharmaceutical and can be purchased over-the-counter, it is very important that you discuss any changes in supplements and medication with your doctor. In many cases, St. John’s Wort is not compatible with other medications or certain conditions, while in others, it is prescribed in conjunction with another medication.
The bottom line is this: evidence shows that St. John’s Wort is an effective natural nootropic for the treatment of depression, but also of other conditions, including wounds, menopause, obsessive-compulsive-disorder, and potentially, seasonal affective disorder.
If you would like to learn more about nootropics and the evidence that supports their use for depression and a range of other brain-related issues, browse our articles at https://nootropicsresources.com.
Sasha is a Nutritional Anthropologist with an M.Sc. in Food and Nutrition. She has been a food, nutrition, and health researcher and writer for six years and also works as an international development consultant.
She is passionate about empowering people to make the best nutrition and health choices in a way that makes cultural and logical sense for each individual and community.
Sasha currently lives in Guatemala with her family and three dogs. In her free time, she cooks, reads, gardens, and goes on adventures with her family around Guatemala and the world.