Hypericum perforatum herb for depression, dosage, safety, risk, danger, interaction with prescription medications

Hypericum perforatum is also known as St johns wort.

Hepatitis treatment
In vitro anti-hepatitis B virus effect of Hypericum perforatum L.
J Huazhong Univ Sci Technolog Med Sci. 2010 Feb; Department of Hepatology and Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
The anti-hepatitis B virus (HBV) effects and its mechanisms of the ethanol extracts of Hypericum perforatum L. (EHP) in vitro were explored. HepG2 2.2.15 cells, a stable HBV-producing cell line, were cultured as the model system to observe the anti-HBV effect. The viral antigens of cellular secretion, HBsAg and HBeAg, were determined by enzyme linked immunosorbent assay (ELISA). The quantity of HBV-DNA released in the supernatant was assayed by real-time PCR. In order to understand the mechanisms of the suppression of HBV replication, all HBV promoters (Cp, Xp, S1p, S2p and Fp) with luciferase reporter gene were transfected into HepG2 cells respectively. Then the activities of viral promoters were examined by luciferase reporter assay. It was found EHP effectively suppressed the secretion of HBsAg and HBeAg from HepG2 2.2.15 cells in a dose-dependent manner, as well as the extracellular HBV DNA. And EHP could selectively inhibit the activity of HBV promoter Fp. Our data suggest that EHP exerts anti-HBV effects via inhibition of HBV transcription, which helps to elucidate the mechanism underlying the potential therapeutic value of EHP.

Hypericum perforatum research studies
Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: A meta-analysis; Rahimi R, Nikfar S, Abdollahi M; Progress in Neuro-Psychopharmacology & Biological Psychiatry (Nov 2008)
Hypericum perforatum is a medicinal plant with established antidepressant properties. The aim of this meta-analysis was to compare the efficacy and tolerability of this antidepressant with selective serotonin reuptake inhibitors (SSRIs) as a group of standard antidepressants. For this purpose, Pubmed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for studies comparing efficacy and/or tolerability of Hypericum with SSRIs in the management of major depressive disorder (MDD). The search terms were: "Hypericum" or "St. John's wort" and "fluoxetine", "paroxetine", "citalopram", "serteraline", "escitalopram", or "fluvoxamine". Data were collected from 1966 to 2008 (up to June). "Clinical response", "remission", "mean reduction in Hamilton Rating Scale for Depression (HAMD) score from baseline", "total adverse events", and "withdrawals due to adverse events" were the key outcomes of interest. Thirteen randomized placebo controlled clinical trials met our criteria and were included. Hypericum does not differ from SSRIs according to efficacy and adverse events in MDD. Lower withdrawal from study due to adverse events by Hypericum is an advantage in management of MDD.

Timing of clinical improvement and symptom resolution in the treatment of major depressive disorder. A replication of findings with the use of a double-blind, placebo-controlled trial of Hypericum perforatum versus fluoxetine.
Neuropsychobiology. 2007;56(2-3):132-7. Papakostas GI, Crawford CM, Scalia MJ, Fava M. Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass. 02114, USA.
Thirty-nine outpatients with depression who responded following a 12-week, double-blind study comparing St. John's wort, fluoxetine or placebo were included in the analysis. In the present work, earlier as well as early clinical improvement during treatment is predictive of greater symptom resolution at endpoint among responders. This was replicated among patients who received active treatment (either St. John's wort or fluoxetine) but not placebo.

Hypericum perforatum and SSRI medications
Q. Are there interactions between Hypericum perforatum and SSRI medications? Can a person take both the drug and the herb together?
   A. Unless the dosage of the drug and the herb and very low, we suggest not taking them the same day, they are both potent. It would be best to first learn how each one works by itself for 2 or 3 weeks before combining, and doing so with medical approval. When combined, the dosages would be at least half or a third of the suggested amounts taken alone.

citalopram depression escitalopram fluoxetine fluvoxamine paroxetine
The combination of this herb with Prozac, Zoloft, Paxil and other anti-depressants is not well understood, caution is advised.