Positive Health Online

Abstract

BECKMAN, SOMMI and SWITZER , Department of Psychiatry, School of Pharmacy, University of Missouri-Kansas City, and Western Missouri Mental Health Center, Missouri 64108-2792, USA conducted a telephone survey of people who had taken St John's wort .

Background

Use of St John's wort is largely unsupervised and unexplored, despite limited available information on its pharmacology, efficacy and side effects.

Methodology

The investigators carried out a telephone survey of 43 individuals who had taken St John's wort to obtain information on demographics, psychiatric and medical conditions, dosage, duration of use, reason for use, side effects, concomitant drugs, professional consultation, effectiveness, relapse and withdrawal effects.

Results

The majority of subjects reported taking St John's wort for depression . 74% did not seek medical advice . The mean dosage used was 475.6±360 mg/day (range 300-1200 mg/day). The mean duration of dosing was 7.3±10.1 weeks (range 1 day-5 years). 84% (n=36) reported an improvement . Of these, 50% (n=18) had a psychiatric diagnosis. 47% (n=20) reported side effects, leading to discontinuation of use in 5 (12%) and 1 emergency room visit. 2 subjects reported symptoms of serotonin syndrome. 3 reported food-drug interactions. 13 subjects experienced withdrawal symptoms on stopping St John's wort. 2 had a depressive relapse .

Conclusion

There is a need for greater consumer and provider awareness of the potential risks of St John's wort in the self-care of depression and related conditions.

References

Beckman SE, Sommi RW and Switzer J. Consumer use of St John's wort: a survey on effectiveness, safety, and tolerability. Pharmacotherapy 20 (5): 568-74. May 2000.