Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Hypericum, most commonly referring to Hypericum perforatum or St. John's Wort, has a long history of use in traditional medicine for mood disorders, but its use in depression is also supported by a substantial body of scientific research. Numerous randomized controlled trials and meta-analyses have evaluated Hypericum extracts, particularly standardized preparations, in the treatment of mild to moderate depression. Overall, these studies have shown that Hypericum is more effective than placebo and similarly effective to standard antidepressant medications (such as selective serotonin reuptake inhibitors) for mild to moderate cases. The active constituents believed to contribute to its effects include hypericin and hyperforin, which may modulate neurotransmitter activity, including serotonin, dopamine, and norepinephrine pathways.

However, the quality and standardization of commercial products vary widely, leading to inconsistencies in efficacy. Additionally, Hypericum is known to cause significant drug interactions by inducing cytochrome P450 enzymes, which can reduce the effectiveness of many prescription medications, including oral contraceptives, anticoagulants, and others. While evidence for its use in severe depression is lacking, the overall scientific support for its use in mild to moderate depression is strong enough to warrant a rating of 4 out of 5. Clinical guidelines in some countries acknowledge its efficacy, but also emphasize caution due to its interaction profile.

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