Q and A: Treat Severe Depression with St. John’s Wort

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St. John's Wort is often used as a treatment for depression, but must be taken continuously.

In every issue of Herbs for Health, professionals from a variety of health-care fields ­answer your questions about using medicinal herbs. Medical doctor Robert Rountree and herbalist Daniel Gagnon responded for this issue.


I am a twenty-four-year-old female, and I suffer from depression and a lot of stress. Although my depression is not constant, it tends to be very severe. After reading the article “Depression: Herbs that Help” (November/December 1996) I began taking St.-John’s-wort extract. I take two 300-mg capsules daily, and I plan to take them for three weeks and then take a break. Do you think this is a good routine, and is there anything more I should know about this herb?
N. D.
Hamilton Square,
New Jersey

The recommended dose of St.-John’s-wort (Hypericum perforatum) for serious depression is 900 mg daily, using a preparation standardized to contain 0.3 percent hypericin. Since it may take two to three weeks before you experience consistent improvements in mood, there would be no advantage in taking a break from therapy. In fact, the longer you take it, the more likely it is to be beneficial.

Its mechanism of action is unclear, although some researchers believe that it has similarities to a class of anti-depressant drugs called mono­amine oxidase inhib­itors. For this reason, there is a theoretical risk (but no published reports) of interactions with prescription ­antidepressants and foods containing vasoactive amines such as wine, chocolate, ­fermented cheeses, and ­bananas.

The most significant side effect of St.-John’s-wort is increased sun sensitivity. If you do take therapeutic doses of hypericum and must spend time in the sun, be certain to use adequate skin protection.
–Robert Rountree

St.-John’s-wort is an excellent herb for people suffering from depression. It must be ingested for at least two to three weeks to start showing its antidepressant results and taken continuously for at least two to three months, without a break, to get maximum results. As with antidepressant drugs, if you stop taking St.-John’s-wort, its effects will decline, which is why I recommend continuous use. Be aware that St.-John’s-wort may photosensitize your skin–with prolonged exposure to the sun or tanning lights, you may develop a rash.

Another herb that helps alleviate depression is lemon balm (Melissa officinalis), an amazingly effective mood elevator and antidepressant. Again, as with St.-John’s-wort, you’ll need to take lemon balm for an extended time period to get maximum results. Don’t forget to take a daily walk at a brisk pace for 30 minutes five times a week to elevate your endorphins (natural hormones in the body which have been found to increase a sense of well being)!
–Daniel Gagnon

Robert Rountree, M.D., is a physician at the Helios Health Center, co-author of Smart Medicine for a Healthier Child, and an advisory board member for the Herb ­Research Foundation.
Daniel Gagnon is a medical herbalist living in Santa Fe, New Mexico. He is a pro­fessional member of the ­American Herbalist Guild, vice-chairman of the Amer­ican Herbal Products Association, and owner of an herbal retail store in Santa Fe.

The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.

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