St. John's Wort Extract

BotanicalmoodStrong dose evidence

Also known as: Hypericum perforatum, hypericum extract, St John's wort, hypericin, hyperforin

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An extract of the flowering tops of Hypericum perforatum standardized to hypericin and often hyperforin, the most studied botanical for mood. A Cochrane review and a later meta-analysis found that standardized extracts outperformed placebo and matched standard antidepressants in mild to moderate depression with fewer side effects. Its major drawback is pharmacology: hyperforin strongly induces CYP3A4 and P-glycoprotein, reducing levels of many medications, which makes it a high-risk ingredient for multi-ingredient products aimed at broad audiences.

Research summary

Hyperforin inhibits reuptake of serotonin, norepinephrine, dopamine, and GABA, while hypericin and flavonoids contribute additional monoaminergic effects.

Dosage

Daily amounts, of extract.

Lowest studiedTypical rangeHighest studiedUpper limit
600–900 mg

300 mg three times daily with meals, for 600 to 900 mg per day, of an extract standardized to 0.3% hypericin. Mood effects build over four to six weeks. Photosensitivity can occur at higher doses, so advise sun protection in label copy.

Standardization: 0.3% hypericin (often also 3–5% hyperforin)

Source material: flowering top extract

Format suitability

  • Capsule
  • Powder
  • Tablet
  • Softgel
  • Gummy
  • Liquid

Bitter, astringent; hypericin is light-sensitive, so use opaque packaging.

Formulation notes

Induces CYP3A4 and P-glycoprotein, lowering levels of oral contraceptives, anticoagulants, immunosuppressants, antiretrovirals, and many other drugs; risk of serotonin syndrome with SSRIs and 5-HTP. Requires a prominent interaction warning and is usually sold as a standalone product.

  • Notable drug interactions
  • Not for pregnancy
  • Restricted in some countries

Sources

  1. St John's wort for major depression. (Linde 2008)PubMed
  2. Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis. (Ng 2017)PubMed
  3. St. John's Wort — ExamineExamine

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