St. John’s Wort is a widely-used herbal supplement. It is typically taken for its apparent antidepressant and anxiolytic properties. Its proponents claim that it is a potent cure for anxiety; side-effect free, reliable, and effective.
Many claim that it is as effective at treating anxiety as some pharmaceutical-grade relaxants and anxiolytics. Some push it as a palliative treatment for depression; a few people even go as far as to say that it is itself a powerful anti-depressant in and of itself.
Yes, few herbal remedies have quite the same popularity and PR backing as St. John’s Wort. It has been in use for a long time, and over the years it has drifted in and out of favour.
Now as natural sleep aids are becoming more popular, St. John’s Wort is again on the rise.
But does this stuff actually work?
We know there are lots of substances out there that claim to do amazing things, but which in reality do absolutely nothing.
So does St. John’s Wort work, or is it another addition to the long list of bogus herbal remedies? Let’s take a look at the scientific studies and see what we can find out. We’ll discuss the benefits, negatives, and potential side effects of St. John’s Wort. We will talk about whether or not it works as advertised, and whether we think people should really be suing it.
Have you been using St. John’s Wort for anxiety? How about as a sleep aid? What do you think? Please share your experiences in the comments section at the end!
Does It Work? – What The Science Says
We wont bother you with waffle about what we think St. John’s Wort does. We’ll jump right into what the studies say.
To kick things off, we recommend that you check out this rather damning study, published in JAMA in 2002. The researchers looked at how St. John’s Wort extract supplementation affected patients with moderate depression compared to placebo. The first finding was that neither St. John’s Wort nor the other studied compound fared better than placebo: “On the 2 primary outcome measures, neither sertraline nor H perforatum was significantly different from placebo.”
The conclusion reached by the authors was pretty unequivocal: “This study fails to support the efficacy of H perforatum in moderately severe major depression. The result may be due to low assay sensitivity of the trial, but the complete absence of trends suggestive of efficacy for H perforatum is noteworthy.”
The authors are quite right to note that few trials show St. John’s Wort as being particularly effective.
Another interesting study worth looking at is this one, published in the Journal of Clinical Psychiatry in 2004. The reason this study is so interesting is because it highlights a major problem that keeps cropping up in clinical trials on St. John’s Wort: non-responders.
The paper’s authors note: “The subjects who did not respond to St. John’s wort extract or placebo in phase 1 were, by and large, not resistant to antidepressant treatment. This suggests that the lack of efficacy found by Shelton et al. in the acute-phase study was unlikely to be the result of a high proportion of treatment-resistant subjects.”
However, it isn’t quite a closed case for St. John’s Wort.
There are plenty of studies showing that St. John’s Wort is an effective treatment for many symptoms of anxiety and depression.
For example, this very robust study published in June 2006 found that “Hypericum perforatum extract WS 5570 at doses of 600 mg/day (once daily) and 1200 mg/day (600 mg twice daily) were found to be safe and more effective than placebo”.
Another study, published in the Journal of Psychopharmacology, found that St. John’s Wort was highly effective at treating the symptoms of major depressive disorder. The conclusion reads: “St John’s wort was significantly more effective than fluoxetine and showed a trend toward superiority over placebo. A (25%) smaller than planned sample size is likely to account for the lack of statistical significance for the advantage (indicating a moderate effect size, d = 0.45) of St John’s wort over placebo.”
So Does It Work?
It seems like St. John’s Wort is nowhere near as effective as some people would have you believe.
Many studies have found it to be ineffective at treating any aspects of anxiety or depression. Some found it to be no more effective than placebo.
Other clinical trials have found that St. John’s Wort is highly unreliable across populations; a sizeable minority of people are clear non-responders to the herb.
So while there is some credence to the claim that it might help reduce some symptoms of depression and anxiety, it is not the reliable, proven anxiolytic that it is marketed as. Much better options are unquestionably out there.