Hypericaceae · flowering tops
St John's wort
Hypericum perforatum
Flowering tops mapped to meta-analyses for mild-to-moderate depressive symptoms versus placebo or older comparators. Interaction risk, not flower poetry, is the first clinical fact.
Safety first
A documented CYP3A4 and P-glycoprotein inducer. It can drop levels of oral contraceptives, transplant immunosuppressants, some antiretrovirals, and many other drugs, and it can stack serotonergically with SSRIs. Photosensitivity is real. This is not a harmless mood tea.
Tradition vs trials
Traditional record. European tradition uses the fresh flowering herb internally for low mood and topically as red oil for bruises. Commission E and ESCOP record both.
Trial literature. Cochrane and other systematic reviews find benefit in some depressive-symptom trials, mainly with standardized hypericin/hyperforin extracts. Severity, product, and interaction risk limit any self-care reading of those reviews.
Practical ranges
Educational ranges — not a prescription. Culinary use is not an extract.
standardized extract (adults)
European trial products often provide about 300 mg extract (commonly 0.3% hypericin or specified hyperforin) three times daily; this is a researched range, not a self-prescription
ESCOP / Cochrane — Educational range only — not a prescription. A licensed clinician individualizes product, dose, and duration.
Pregnancy, nursing, children
- Pregnancy. Insufficient reliable data; avoid unless a clinician directs otherwise.
- Nursing. Insufficient reliable data; avoid unless a clinician directs otherwise.
- Children. Insufficient reliable data; avoid unless a clinician directs otherwise.
Contraindications
- transplant immunosuppression
- oral contraceptive reliance without clinician review
- concurrent serotonergic drugs
- known photosensitivity disorders
Key interactions
- CYP3A4 and P-gp substrates · contraindicated
Induces metabolism/transport of calcineurin inhibitors, many NNRTIs/PIs, some anticoagulants, and many others.
- oral contraceptives · avoid
Documented contraceptive failure reports.
- SSRIs / triptans / other serotonergics · avoid
Serotonin-syndrome risk.