Adverse effects profile of the herbal antidepressant St. John's wort (Hypericum perforatum L.)
Objective: This paper provides a systematic
review of adverse drug reactions (ADRs) associated with
the use of extracts of the herb St. John's wort (Hyperi-
cum perforatum L.) for the treatment of mild to mod-
erate depression.
Methods: Searches of four computerized literature da-
tabases were performed for records of (ADRs). Manu-
facturers of hypericum products, the international drug
monitoring centre of the World Health Organization
(WHO) and the national drug safety monitoring bodies
of Germany and the United Kingdom were also con-
tacted for information.
Results: Information on (ADRs) originates from case
reports, clinical trials, post-marketing surveillance and
drug monitoring studies. Collectively, the data suggest
that hypericum is well tolerated, with an incidence of
adverse reactions similar to that of placebo. The most
common adverse eects are gastrointestinal symptoms,
dizziness/confusion and tiredness/sedation. A potential
serious adverse eect is photosensitivity, but this ap-
pears to occur extremely rarely.
Conclusions: Hypericum has an encouraging safety
pro®le. However, as most of the current data originate
from short-term investigations, more long-term studies
are desirable.