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Home > Anti-aging Research >  Antidepressants > St. John's Wort

St. John's Wort (Hypericum perforatum)

Related Topics:

• St. John's wort / 5-HTP / SAMe / NADH / Omega-3 / tyrosine / acetyl-l-carnitine / DHEA / phenylalanine / ginkgo / phosphatidylserine / folate / antidepressants

Specific Recommendations:

• Kira® (LI 160 extract) St. John's wort at iHerb
• Perika (WS 5570 extract) at iHerb
• St. John's wort products at iHerb
• Remotiv (Ze 117 extract)
• Vitacost St. John's wort products

CME/CEM:

• Depression Management - ContinuingEducation.com, exp. 12/31/02 - see "St. John's Wort (SJW)" about three forth the way down the page.

Ze 117 Extract (Not available in the US, Remotiv brand in Germany):

• St. John's Wort Equivalent to World's Best-selling Antidepressant - herbs.org
• No one can argue placebo effect on this study:  St. John's wort extract Ze 117 (Hypericum perforatum) inhibits norepinephrine and serotonin uptake into rat brain slices and reduces 3-adrenoceptor numbers on cultured rat brain cells - Pharmacopsychiatry 2001 Jul;34 Suppl 1:S56-60 - "The Ze 117 extract was more selective for the uptake of NE than for that of 5-HT. The maximal extent of uptake inhibition by Ze 117 extract was comparable to that of imipramine (IMI), desipramine (DMI) or fluvoxamine for 5-HT, but lower for NE transport, than that of the synthetic antidepressants"
• Equivalence of St John's wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression - Int Clin Psychopharmacol 2000 Mar;15(2):61-8 - "We concluded that hypericum and fluoxetine are equipotent with respect to all main parameters used to investigate antidepressants in this population. Although hypericum may be superior in improving the responder rate, the main difference between the two treatments is safety. Hypericum was superior to fluoxetine in overall incidence of side-effects, number of patients with side-effects and the type of side-effect reported"
• Comparison of St John's wort and imipramine for treating depression: randomised controlled trial - BMJ 2000 Sep 2;321(7260):536-9 - "Among the 157 participants taking hypericum mean scores on the Hamilton depression scale decreased from 22.4 at baseline to 12.00 at end point; among the 167 participants taking imipramine they fell from 22.1 to 12.75 ... This Hypericum perforatum extract is therapeutically equivalent to imipramine in treating mild to moderate depression, but patients tolerate hypericum better" - Bottom line, the SJW group rated more depressed than the imipramine group before the study and less depressed than the imipramine group after the study.  There are doctor's who would argue that they should have used 225 mg of imipramine but then they could have tried 750 mg on the Ze 117 extract also.- Ben
• Comparison of St. John's Wort and Imipramine for Treating Depression: Randomised Controlled Trial - Medscape, 9/00
• Comparison of St John's wort and imipramine for treating depression: randomised controlled trial - BMJ 2000 Sep 2;321(7260):536-9
• St. John's Wort Trumps Depression Drug - WebMD, 9/1/00
• Comparison of St John's wort and imipramine for treating depression: randomised controlled trial - BMJ 2000;321:536539 (2 September) - "Among the 157 participants taking hypericum mean scores on the Hamilton depression scale decreased from 22.4 at baseline to 12.00 at end point; among the 167 participants taking imipramine they fell from 22.1 to 12.75"
• Medline search of Ze 117

LI 160 Extract (Kira® Brand LI-160 extract in the US, Jarsin 300 brand in Germany):

• St. John's Wort Useful for Severe Depression - WebMD, 2/10/05 - "At the end of six weeks, 71% of the patients taking St. John's Wort and 60% of those taking Paxil had responded to treatment. Half of the St. John's Wort-treated patients and 35% of the Paxil-treated patients were free of depression symptoms"
• New Use Suggested For St. John's Wort - Psychiatric News, 9/17/04 - "St. John's wort "may be a useful therapeutic alternative in the acute treatment of mildly to moderately severe somatoform disorder." ... The St. John's wort used in this study is from a specific company, Lichtwer, with a long history of outstanding quality control and a consistent approach to the processing of St. John's wort. Individuals going to health food stores and purchasing St. John's wort are not likely to find the same consistency in the quality of the product" - Lichtwer is the LI-160 extract sold under the band name Kira® in the U.S.
• St. John's Wort as Effective as Zoloft® against Depression - New Hope Natural Media Online, 6/13/02 - "St. John's wort (SJW), a popular herbal remedy, is at least as effective as the prescription drug sertraline (Zoloft®) in the treatment of depression and causes fewer side effects, according to a new study published in Canadian Family Physician (2002;48:905–8). This report confirms dozens of other studies demonstrating SJW is an effective treatment for mild-to-moderate depression, and contradicts two controversial studies suggesting the herb is of little or no benefit ... After 12 weeks, the severity of depression had decreased by an average of 50.2% in the SJW group and by 41.6% in the sertraline group"
• Effect of Hypericum perforatum (St John's Wort) in Major Depressive Disorder: A Randomized Controlled Trial - JAMA, 4/10/02 - "extract (LI-160) ... neither sertraline nor H perforatum was significantly different from placebo ... Dr Davidson holds stock in Pfizer"
  • Money colors drug research - USA Today, 1/22/03 - "industry funding makes it 3.6 times more likely that a study result will be favorable to the sponsor"
• St. John's Wort Not Effective -- Again - WebMD, 4/9/02
• Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10 - Pharmacopsychiatry 1997 Sep;30 Suppl 2:81-5 - "6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in severely depressed patients according to ICD-10 ... mean values 25.3 to 14.5 in the LI 160 group and 26.1 to 13.6 in the imipramine group ... Regarding adverse events, the nonrejection of the nonequivalence hypothesis denotes a superiority of the herbal antidepressant. These main result indicate that LI 160 might be a treatment alternative to the synthetic tricyclic antidepressant imipramine in the majority of severe forms of depressions"
• Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study - Medline/Clin Ther 2000 Apr;22(4):411-9, 4/00 - "Clinical response (defined as a > or =50% reduction in HAM-D scores) was noted in 47% of patients receiving hypericum and 40% of those receiving sertraline ... The [LI 160] hypericum extract was at least as effective as sertraline in the treatment of mild to moderate depression in a small group of outpatients"
• Neuroendocrine evidence for dopaminergic actions of hypericum extract (LI 160) in healthy volunteers - Biol Psychiatry 1999 Aug 15;46(4):581-4 - "Following HP relative to placebo, there was a significant increase in plasma GH [growth hormone] and a significant decrease in plasma PRL [prolactin]" - Note:  Prolactin is bad for your sex like.
• Hypericum LI 160 inhibits uptake of serotonin and norepinephrine in astrocytes - Brain Res 1999 Jan 23;816(2):358-63 - "We found that LI 160 inhibited both serotonin and norepinephrine uptake in a dose-dependent manner"
• Acute effects of LI 160 (extract of Hypericum perforatum, St John's wort) and two of its constituents on neuroendocrine responses in the rat - J Psychopharmacol 2000;14(4):360-3 - "LI 160 also lowered plasma prolactin and prevented the increase in plasma prolactin following haloperidol administration" - Note: Prolactin is bad for your sex life.
• Effectiveness and tolerance of the hypericum extract LI 160 in comparison with imipramine: randomized double-blind study with 135 outpatients - J Geriatr Psychiatry Neurol 1994 Oct;7 Suppl 1:S19-23 - "a parallel reduction of the Hamilton score from 20.2 to 8.8 (LI 160, n = 67) or from 19.4 to 10.7 (imipramine, n = 68) ... In the LI 160 group fewer and milder side effects were found as compared to imipramine"
• St. John's wort study was financed and biased by Pfizer, makers of Zoloft - Ben
• Questions About St. John's Wort - Intelihealth, 4/25/01
• Study: St. John's wort ineffective in severe depression - CNN, 4/18/01 - "At the time the study was done, Pfizer also sold St. John's wort, but the company stopped selling herbs last year because it wasn't profitable" - That's the whole problem in a nutshell, Ben
• Depressing News: St. John's Wort May Not Work After All, Don't Believe the Hype, Says Researcher - WebMD, 4/17/01
• Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study - Medline/Clin Ther 2000 Apr;22(4):411-9, 4/00 - "Clinical response (defined as a > or =50% reduction in HAM-D scores) was noted in 47% of patients receiving hypericum and 40% of those receiving sertraline ... The [LI 160] hypericum extract was at least as effective as sertraline in the treatment of mild to moderate depression in a small group of outpatients"
• Medline search of LI 160

WS 5572 Extract (Perika Brand in US, Neuroplant 300 brand in Germany):

• Medline search of WS 5572

WS 5570 Extract (contains at least 4% hyperforin but I don't believe it's available)/(Perika Brand  in US, Neuroplant 300 brand in Germany):

• New Study Finds Different Results on Efficacy of St. John's Wort for Depression - Clinical Psychiatry News, 3/05 - "extract WS 5570 ... Patients whose initial response was insufficient could increase the dose of hypericum extract to 1,800 mg/day or of paroxetine to 40 mg/day ... response rates were 60% in the hypericum group and 63% in the paroxetine group, while remission rates were 46.6% with hypericum and 42.9% with paroxetine" - Note:  The WS 5570 extract is sold under the Perika(R) brand name.
• Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort) - NPI Center, 2/11/05 - "This extract (WS(R) 5572) contains the same patented, standardized and stabilized hyperforin content as WS(R) 5570, and is marketed as Perika(R) St. John's Wort by Nature's Way Products, Inc"
• St. John's Wort Useful for Severe Depression - WebMD, 2/10/05 - "At the end of six weeks, 71% of the patients taking St. John's Wort and 60% of those taking Paxil had responded to treatment. Half of the St. John's Wort-treated patients and 35% of the Paxil-treated patients were free of depression symptoms"
• Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial - Am J Psychiatry 2002 Aug;159(8):1361-6
• Neuroendocrine effects of Hypericum extract WS 5570 in 12 healthy male volunteers - Pharmacopsychiatry 2001 Jul;34 Suppl 1:S127-33
• Medline search of WS 5570

STW3-VI Extract:

• Comparative Efficacy and Safety of a Once-Daily Dosage of Hypericum Extract STW3-VI and Citalopram in Patients with Moderate Depression: A Double-Blind, Randomised, Multicentre, Placebo-Controlled Study - Pharmacopsychiatry. 2006 Mar;39(2):66-75 - "From almost identical baseline values of 21.9 +/- 1.2 points (hypericum extract), 21.8 +/- 1.2 points (citalopram) and 22.0 +/- 1.2 points (placebo), the HAMD score was reduced to 10.3 +/- 6.4 (hypericum extract), 10.3 +/- 6.4 (citalopram) and 13.0 +/- 6.9 (placebo), respectively ... Significantly more adverse events with "certain", "probable" or "possible" relation to study medication were documented in the citalopram group ... hypericum extract STW3-VI is a good alternative to chemically defined antidepressants in the treatment of outpatients with moderate depression"

Other News:

• St. John’s Wort - Vitacost Health Library
• St. John’s Wort for Weight Control - Vitacost Health Library
• Depression Protocol - Life Extension Foundation
• St. John's Wort, Nature's Feel Good Herb - Ray Sahelian, M.D.
• St. John's wort - Compiled by Chad Bradshaw, Pharm.D
• St. John’s Wort Extract - Dr. Murray - "German doctor's now prescribe St. John's wort extract 8 times more often than Prozac ... These doctors are knowledgeable about both medicines, but clearly favor St. John's wort extract. Why? The simple answer is that St. John's wort produces equal or better results in relieving depression, but has far fewer side effect. Over 25 double-blind randomized trials involving a total of 1,757 outpatients with mild to moderately severe depression have shown St. John's wort extracts standardized for hypericin to yield excellent results in the treatment in depression with virtually no side effects"
• I read somewhere that when taking St. John’s wort extract that it is important to stay away from the sun and avoid red wine and cheese. Is this true? - Dr. Murray
• St. John's Wort (Hypericum perforatum L.) - M. D. Anderson Cancer Center
• St. John's Wort review - ConsumerLab.com, 2/15/07 - "most of the herbal supplements that we purchased failed to meet quality standards. Two contained less St. John's wort compounds than claimed. Two others were contaminated with cadmium and/or lead. And two more lacked proper label information"
• Botanical and dietary supplements for mood and anxiety in menopausal women - Menopause. 2006 Dec 28 - "Five of seven trials of St. John's wort for mild to moderate depression showed a significant improvement"
• Serotonin syndrome has been reported in patients who used both St. John's Wort and an SSRI - Clinical Psychiatry News, 11/06 - "The evidence is strongest for the psychotropic herb St. John's wort, which appears to induce cytochrome P450 (CYP450) enzyme systems, particularly 3A4, leading to substantial reductions in drug substrates, including antivirals and cancer chemotherapy agents"
• Is St. John's Wort Effective for Major Depression? - New Hope Natural Media Online, 8/10/06
• Black Cohosh/St. John’s Wort could ease menopause symptoms - Nutra USA, 3/2/06 - "The most common symptom of menopause, “hot flashes” characterized by sudden waves of body heat, decreased by 53.4 percent among women who took the Black Cohosh-St. John's Wort combo in the trial, while psychological, or “psyche”, symptoms reportedly dropped by 56.4 percent"
• St. John's Wort May Not Stop Major Depression - WebMD, 5/24/05
• St. John's Wort Only Minimally Effective In Relieving Major Depression, Review Confirms - Science Daily, 5/22/05 - "St. John’s Wort products should be avoided if they do not provide important content information, such as the amount of total extract contained, the extraction fluid used and the ratio of raw material to extract" - Note:  Most of the studies I've seen involve the LI 160 extract sold in the US under the Kira® brand.
• St. John's Wort and Plavix May Be Risky Combo - WebMD, 3/8/05 - "St. John's wort, used by many for depression, increases the effect - and the bleeding risk - of Plavix, a widely used blood thinner"
• St. John's Wort - Imatinib Drug Interactions - Medscape, 12/17/04 - "Coadministration of imatinib with St. John's wort may compromise imatinib's clinical efficacy"
• St. John’s Wort: Good for More than Depression - Healthwell, 10/21/04 - "SDs are a group of conditions characterized by several ongoing physical symptoms that cannot be explained by any identifiable illness ... Among those participants receiving SJW, 44% reported being completely improved, compared with only 25% in the placebo group. In contrast, 45% of the participants in the placebo group felt unchanged or worse compared with 17% in the SJW group. By the end of the study, one half of the participants taking SJW had improved so much that they were no longer considered to have SD"
• St. John's Wort Thwarts Cancer Drug - WebMD, 10/26/04
• St John's Wort May Reduce Bioavailability of Conventional Medications - Doctor's Guide, 7/6/04
• St. John's Wort Depletes Cancer-Fighting Drug - WebMD, 3/26/04 - "when St. John's wort is taken in combination with Gleevec, it caused the amount of Gleevec in the blood to drop by 30%"
• Caution: St. John's Wort Ingredients Vary - WebMD, 2/10/04
• What's Really In Your St. John's Wort Tablets? - Intelihealth, 2/9/04 - "Actual amounts of hypericin ranged from 1.7 to 38.5 percent of the claimed amount"
• St. John's Wort -  Natural Foods Merchandiser, 10/03 - "Recently, in a large trial comparing SJW with the conventional antidepressant imipramine, researchers concluded SJW is as effective as imipramine and is better tolerated by patients.13 In a newer, larger trial (240 participants) comparing SJW directly with fluoxetine, researchers concluded SJW was as effective and safer than fluoxetine, particularly in patients suffering depression and anxiety"
• St John's Wort Alters Enzymes Involved in the Metabolism of About 50% of Over-the-Counter and Prescription Medications - Doctor's Guide, 9/18/03 - "long-term administration of St John's wort may result in diminished clinical effectiveness or increased dosage requirements for all CYP 3A4 substrates, which represent at least half of marketed medications" - The way I understand it, the enzyme that SJW increases protects the liver.  JAMA always seems to be biased against supplements, which might be why they didn't mention that.  Have they ever mentioned the pitfalls of prescription drugs?
• St. John's Wort Increases Metabolism Via CYP 3A4 - Medscape, 9/16/03
• St. John's Wort for Depression - Clinical Psychiatry News, 1/03 - "Most St. John's wort preparations are standardized to the hypericin component. This compound has been shown to reduce 5-hydroxytryptamine (5-HT) receptor density; weakly inhibits reuptake of 5-HT, norepinephrine, and dopamine; and binds to -aminobutyric acid (GABA) receptors ... It also has MAO inhibitor activity ... In biochemical and animal studies, the researchers wrote, hyperforin also inhibits the synaptosomal uptake of 5-HT, noradrenaline, dopamine, glutamate, and GABA"
• St. John's Wort May Help Depression in Children - Clinical Psychiatry News, 1/03
• Antidepressants Aren't All They're Cracked Up to Be - Clinical Psychiatry News, 1/03 - "The fact is, the stringent inclusion and exclusion criteria routinely used in pharmacologic antidepressant clinical trials enable investigators to paint an unrealistically rosy picture of the drugs' performance. This renders the trials largely irrelevant to real-world clinical practice" - That's an important consideration with the Pfizer (makers of Zoloft) funded St. John's wort study.
• St. John's Wort and Chemo Don't Mix - WebMD, 8/20/02 - "Taking St. John's wort during chemotherapy could jeopardize the effectiveness of cancer treatment" - Again, I'm not a doctor but the way I understand it, SJW increases an enzyme that protects the liver.  It seems like that would be a good thing for most people.  Again, why didn't the media mention that instead of being so one sided?
• St. John's Wort: Effective, with Caveats - Nutrition Science News, 3/02 - "Using the Hamilton Rating Scale for Depression, 47 percent of those taking St. John's wort improved compared with 40 percent of those taking the sertraline ... Hyperforin increases the effectiveness of norepinephrine, dopamine, L-glutamate, and gamma-amino butyric acid (GABA), as well as serotonin. Researchers in the Department of Pharmacology at the University of Frankfurt in Germany concluded, "no other antidepressant compound exhibits a similar broad uptake-inhibiting profile.""
• Hypericum, Drug Interactions, and Liver Effects - Medical Herbalism, Medical Herbalism (2000)11(2):16) - "The specific enzyme system whose activity was increased in the test subjects is the CYP3A, part of the p450 microsomal enzyme system, responsible for Phase I detoxification in the liver"
• Prozac and I'm sure others alter the P450 enzymes also.  See:
• Characterising Fluvoxamine Metabolism - Doctor's Guide, 4/19/02 - "the higher fluvoxamine doses inhibited CYP1A2 and CYP2C19 by approximately 75 to 80 per cent. The inhibition with the lower doses was around 40 to 50 per cent"
• A Novel Mechanism For St John's Wort Drug Interactions - Doctor's Guide, 1/25/02
• Depression Management - ContinuingEducation.com, exp. 12/31/02 - "The results of at least one trial suggest that Hypericum, used in higher doses, may be considered a therapeutic alternative in patients with moderate to severe depression"
• Evaluation of the Association Between St. John's Wort and Elevated Thyroid-Stimulating Hormone - Medscape, 12/01 - "This study suggests a probable association between St. John's wort and elevated TSH levels ... In one patient, TSH dropped from 18.63 to 5.37 µU/ml 1 month after discontinuing St. John's wort, and subsequently to 1.32 µU/ml 6 months later. In the second patient, TSH decreased from 14.76 to 3.23 µU/ml 1 month after discontinuation of the herb ... Although the similarities between St. John's wort and tricyclic antidepressant drugs are less clear, it has been postulated that tricyclic antidepressants interfere with the hypothalamic-pituitary-thyroid axis through noradrenergic or serotonergic systems, indirectly decreasing T4 or triiodothyronine (T3) levels in the blood"
• Is St. John's wort an effective treatment for depression? - Nutrition Science News, 9/01
• St. John's Wort Vs. Drugs - Nutrition Science News, 6/01 - "Yet recent clinical trials have shown that St. John's wort works as well as Prozac, Zoloft and other leading antidepressant drugs for treating mild to moderate depression"
• Hypericin May Be Potential Candidate For Treating Esophageal Cancer - Doctor's Guide, 5/22/01 - "Hypericin, the active ingredient in St. John’s Wort, a popular herbal remedy for depression, may be a potential candidate for treating esophageal and other tumors"
• Effects of long-term administration of hypericum extracts on the affinity and density of the central serotonergic 5-HT1 A and 5-HT2 A receptors - Pharmacopsychiatry 1997 Sep;30 Suppl 2:113-6 - "the number of both 5-HT1 A and 5-HT2 A receptors were significantly increased by 50% compared to controls"
• Popular Herb Works for Obsessive-Compulsive Disorder - WebMD, 8/17/00
• Herb May Curb PMS - WebMD, 8/7/00
• St. John's Wort Passes Muster - Nutrition Science News, 4/00
• Hypericum, Drug Interatcions, and Liver Effects  - MedHerb.com, 2/00 - "Endogenous hormones metabolized by the CYP3A enzyme system - estradiol, estriol, testosterone, cortisol"
• Study 20 - The Hypericum Homepage - "Both serum-cortisol and serum-prolactin were lowered significantly after three weeks of treatment with hypericum extract in male rats."
• Natural Remedies for Depression - Nutrition Science News, 2/99
• Antidepressant Can Change Personality Traits In Healthy People - Doctor's Guide, 3/2/98
• Scientists Study How Light Activates St. John's Wort Chemical - Doctor's Guide, 12/4/97
• Hypericum (St. John's Wort) & Depression Home Page
• Brain's Serotonin System Declines With Age, Researchers Report - Doctor's Guide, 10/29/97
• St. John's Wort may offer herbal relief for depression - CNN, 8/3/96
• Study: Anti-depressant helps relieve severe PMS - CNN, 9/23/97

I'm not a doctor and what I write should not be taken as medical advice. With that said, I should be able to talk about what I've read without being sued for medical malpractice.  (Isn't there something in the First Amendment?).

The more I read about St. John's wort, the more I'm convinced that it the best anti-depressant on the market - prescription or non-prescription. St. John's has several advantages over other anti-depressants. For one thing, it increases all three of the brains primary nero-transmitters - serotonin, norepinephrine and dopamine (dopamine and norepinephrine are aphrodisiacs, norepinephrine is associated with increased energy). The only other anti-depressant that does that is Effexor, but it is week on norepinephrine and dopamine. One of the things that used to worry me about St. John's wort was that most of the studies were done comparing it to imipramine and I didn't believe that imipramine was a very good anti-depressant because it is seldom used. After doing more research, I discovered that imipramine is one of the most effective anti-depressants available but most people prefer other anti-depressants because of the severe side effects of imipramine.

There is a new anti-depressant called reboxetine, which is made by Upjohn and sold in Europe and awaiting FDA approval in the US. In trials, patients on reboxetine and imipramine had mean Hamilton scores of 1.1 while patients on fluoxetine (Prozac) had a mean score of 2.6 and patients on placebo had a score of 4.7 (Severe depression responds to new class of antidepressants - Reuters, 6/9/98). What that shows is that both reboxetine and imipramine are nearly identical in effectiveness and are more than twice as effective as Prozac. The advantage of reboxetine over imipramine is that it has much less side effects than imipramine. Yet, in every study comparing imipramine and St. John's wort, the difference in the results was negligible. Plus, St. John's wort has far less side effects.

There are several other advantages to St. John's wort. It is a mild inhibitor of both MAO-A and MAO-B. St. John's wort also inhibits the action of interleukin-6, a cytokine that may contribute to the increased cortisol production noted in major depression.

St. John's wort has anti-viral and anti-bacterial properties. It also contains carotenoids, flavonoids and beta-sitosterol which have been associated with decreased cancer and anti-oxidant effects. It contains proanthocyanidins which is the same compound at Pycnogenol (20 times more powerful than vitamin C and 50 times more so than vitamin E).

I read articles claiming that St. John's wort is only for mild to moderate depression. I guess they say that because there is only one trial that I know of where is has used for severe depression.  In that trial, St. John's wort compared quit favorably with imipramine (one of the most effective anti-depressants available).

St. John's wort has been used in trials up to 3600 mg per day.  It seems like in all the studies, they used 300 mg of St. John's wort as the equivalent of 25 mg of imipramine.  If you use the Vorbach/Arnoldt 1997 study and assume a linear relationship, I calculate that you need 12.5% more St. John's wort and come up with 2700 mg of St. John's wort should equal 200 mg of imipramine (the amount of imipramine used for severe depression).  Again, you should always do things in conjunction with as physician.  One reason is that there is the concern over serotonin syndrome which can be fatal.

Ben

Related Searches:

• Doctor's Guide search of wort
• Doctor's Guide (2) search of hypericum
• Intelihealth search of wort
• Life Extension Foundation search
• Medline search of hypericum wort
• Medscape search of hypericum wort
• The Natural Pharmacist search of wort
• Nutrition Science News search
• WebMD search of wort

Related Sites:

• Natural Antidepressant News & Views

Recommended Reading:

• Books on St. John's wort

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