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 How does St. John's wort work?  
The following is one in an ongoing series of columns entitled Natural Medicine Research by . View all columns in series
Ray Sahelian Over the past three years St. John's wort has become one of the most popular herbs due to its consistent and effective antidepressant actions. Many Americans are starting to substitute this herb for pharmaceutical antidepressants. But how does this herb work? Up to now we still don't exactly know which brain chemical systems are most influenced. Researchers at the School of Pharmacy, at Temple University in Philadelphia did a review of published antidepressant mechanism(s) of action of St. John's wort. Although the authors of the study are still not clear, they believe that St. John's wort mechanism of action is similar to that of the synthetic antidepressants, such as the selective serotonin-reuptake inhibitors (such as Prozac) or monoamine oxidase (MAO) inhibitors. But they add that the inhibition by this herb is weak relative to the pharmaceutical drugs and that other mechanisms are possible.

Comments: Having reviewed the published studies with this herb, I tend to agree that the clinical efficacy of St. John's wort is probably attributable to the combined contribution of several mechanisms, each one too weak by itself to account for the overall effect. This is what makes St. John's herb a special herb. By working on several brain chemical systems, its overall benefits are enhanced while the possible side effects are reduced.

Bennett DA Jr, Phun L, Polk JF, Voglino SA, Zlotnik V, Raffa RB. Neuropharmacology of St. John's Wort. Ann Pharmacother 1998 Nov;32(11):1201-8

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 About The Author
Ray Sahelian, M.D., is a popular and respected physician who has been seen on numerous television programs including NBC Today, Dateline NBC, and CNN, and quoted by countless major magazines such as Newsweek He......moreRay Sahelian MD
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