Tag Archives: interaction

St. John’s Wort – A Controversial Supplement

St. John’s Wort is a herbal supplement made from a tall flowering plant called Hypericum perforatum that has yellow star-shaped petals. St. John’s Wort has been used for centuries as a homeopathic remedy for an array of ailments spanning the healing of wounds, to ‘hallucinations” and more recently, depression. Only a couple of its uses have been scientifically backed. It has gained quite the reputation for bring problematic, as it can cause serious interactions with other supplements and medications, as well as adverse side effects.

Herb of Many Names

St. John’s Wort goes by many other names as well which include (but are not limited to):

  • Perforate
  • Amber
  • Barbe de Saint-Jean
  • Demon Chaser
  • Fuga Daemonum
  • Goatweed
  • Tipton’s weed
  • Klamath weed

St. John’s Wort and Depression

The most conclusive studies conducted on the supplement have been on its potential efficacy in managing symptoms of depression. Reputable studies have observed that St. John’s Wort performed better than placebos when it came to helping manage symptoms of mild-to-moderate depressive disorder. It is not meant to replace prescribed medication for depression but in some cases, may effectively supplement treatment. Studies have not proven if St. John’s Wort can help depression in children, as studies have only been performed on adults with the condition. Research also suggests mild potential benefits for OCD sufferers as well as atopic dermatitis.

St. John’s Wort and Other Ailments

Research has proven inconclusive on the treatment or curative properties of St. John’s Wort for other conditions such as: seasonal affective disorder (SAD), anxiety, ADHD, pain, PMS or severe depression. More studies are needed to prove any benefit for these conditions.

Potential Side Effects

As is the case with most medications and supplements, St. John’s Wort is not risk-free. Side effects that have been reported include: trouble sleeping (insomnia in some cases), fatigue, anxiety and irritability, diarrhea, headaches, skin rash, photo-sensitivity and restlessness.

Dangerous Interactions

Research and consumer reports have shown that taking St. John’s Wort can render oral contraceptives (birth control) ineffective. Furthermore, dangerous interactions could occur when St. John’s Wort is taken with such medications as: Warfarin, SSRI antidepressants, cyclosporine, digoxin, antiretroviral medications (used to treat HIV), theophylline or certain migraine medications. Due to the many potential interactions St. John’s Wort may cause, it is of vital importance to talk to your doctor about the medications you are taking before trying St. John’s Wort.

A Contentious Remedy

Because of all the potential drug interactions and side effects St. John’s Wort is associated with, it is actually banned in certain countries like France. In some countries it is only available through prescription so the doctor must sign off before the patient can begin taking it. Recently, countries like Canada are required to update St. John’s Wort labels to include adequate warnings about the potential issues the supplement can cause.

The Bottom Line

While it may certainly provide benefits to certain patients that would outweigh its risks, overall it is regarded is a controversial supplement within the medical community and should be used with caution (especially when it comes to those with cardiovascular disease or people taking birth control).

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Medication Safety Tips (Part 1)


Modern medications are responsible for vastly improving healthcare and life longevity, however, they are certainly far from risk free. When used correctly and appropriately, medications can save lives and better thousands of health conditions, but there is always the potential for toxicity due to accidental misuse or overdose, drug interactions or unsafe use of certain medications (such as while pregnant). The CDC reports over 700,000 medication-related ER visits annually in the United States. Many medication mishaps are preventable by following these key safety steps:

  1. Pay close attention to the directions as well as your pharmacist’s tips. It is estimated that between 20-50% of patients don’t take their medications properly, resulting in potentially fatal mix-ups. For example, some medications are only to be taken once weekly and taking them daily could be dangerous. It is extremely important to ensure you know the correct directions and dosage of each of your medications. Do not crush or alter the medication in any way unless it says so on the container.
  2. Make a list and check it twice! If you can’t name all your drugs and dosages, you should keep a list handy in your wallet or purse of all your medications and prescribed dosages to show a new pharmacist, doctor, nurse or in case of emergency.
  3. Think before reaching for OTC medications. Though many people don’t take OTC medications as seriously as they do prescription pills, OTC drugs also carry significant risks if misused such as internal bleeding or liver damage. There are many that can interact with prescribed medications, worsen pre-existing conditions such as heart disease, or conflict with other commonly used OTC medications.
  4. Treat Supplements like medications. Most people think supplements are “no biggy”, but they can actually be pretty dangerous when taken incorrectly or with the wrong medications or medical conditions. Some supplements can even render your medication ineffective. It is also important to tell your doctor about any supplements you are taking or wish to take.
  5. Keep an eye on any new side effects. You don’t need to be alarmed or too worried about listed side effects of medications as most of them are quite rare. However, it is a good idea to keep an eye on any changes you notice since taking the new medication and let your doctor or pharmacist know at your next appointment. If the side effects are serious, seek emergency treatment right away.

Well there you have the first few of our medication do’s and don’ts. Keep an eye out for Part 2 next.  Thanks for visiting DocChat! Remember, our board-certified physicians are on standby 24/7/365 if you have any medical or medication related inquiries.