Monday, October 6, 2008

ST. JOHN'S WORT - Hypericum Perforatum

St John's wort (pronounced IPA: /sɪndʒənsˈwɝt/) used alone refers to the species Hypericum perforatum, also known as Tipton's Weed or Klamath weed, but, with qualifiers, is used to refer to any species of the genus Hypericum.

Therefore, H. perforatum is sometimes called Common St John's wort to differentiate it. The species of Hypericum have been placed by some in the family Hypericaceae, but more recently have been included in the Clusiaceae. Approximately 370 species of the genus Hypericum exist worldwide with a native geographical distribution including temperate and subtropical regions of North America, Europe, Asia Minor, Russia, India, and China.

Extracts of yellow-flowering Hypericum perforatum L. (St. John's wort) have been recommended traditionally for a wide range of medical conditions. The most common modern-day use of St. John's wort is the treatment of depression. Numerous studies report St. John's wort to be more effective than placebo and equally effective as tricyclic antidepressant drugs in the short-term treatment of mild-to-moderate major depression (1-3 months). It is not clear if St. John's wort is as effective as selective serotonin reuptake inhibitor (SSRI) antidepressants such as sertraline (Zoloft®).

What St. John's Wort Is Used For

  • St John's wort is today most widely known as a herbal treatment for major depression. In some countries, such as Germany, it is commonly prescribed for mild depression, especially in children, adolescents, and where cost is a concern. Standardized extracts are generally available over the counter – however, in some countries (such as Ireland) a prescription is required. Extracts are usually in tablet or capsule form, and also in teabags and tinctures.
  • St. John's wort has been used for centuries to treat mental disorders and nerve pain.
  • St. John's wort has also been used as a sedative and a treatment for malaria, as well as a balm for wounds, burns, and insect bites.
  • Today, St. John's wort is used by some for depression, anxiety, and/or sleep disorders.

Other Medical Uses Of St. John's Wort

It may decrease alcohol intake. The constituent hyperforin, (found in the plant), appears to be responsible for decreasing alcohol consumption.

The aerial parts of the plant can be cut and dried for later delivery of the active ingredients in the form of an herbal tea with a pleasant, though somewhat bitter, taste.

Hyperforin, a major constituent, has also been found to have antibacterial properties; in ultrapurified form a concentration of 0.1 mg/ml kills methicillin-resistant Staphylococcus aureus.

Hyperforin can stimulate the release of the neurotransmitter norepinephrine, leading to speculation that it might alleviate the symptoms of attention-deficit hyperactivity disorder (ADHD). A randomized controlled trial of St. John's wort found no significant difference between the botanical and placebo in the management of ADHD symptoms over eight weeks.

Side Effects and Cautions

* St. John's wort may cause increased sensitivity to sunlight. Other side effects can include anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction.
* Research shows that St. John's wort interacts with some drugs. The herb affects the way the body processes or breaks down many drugs; in some cases, it may speed or slow a drug's breakdown. Drugs that can be affected include:
o Antidepressants
o Birth control pills
o Cyclosporine, which prevents the body from rejecting transplanted organs
o Digoxin, which strengthens heart muscle contractions
o Indinavir and possibly other drugs used to control HIV infection
o Irinotecan and possibly other drugs used to treat cancer
o Warfarin and related anticoagulants
* When combined with certain antidepressants, St. John's wort may increase side effects such as nausea, anxiety, headache, and confusion.
* St. John's wort is not a proven therapy for depression. If depression is not adequately treated, it can become severe. Anyone who may have depression should see a health care provider. There are effective proven therapies available.
* Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

More Precaution (Adverse Effects) On St John's wort

At large doses, St John's wort is poisonous to grazing livestock (cattle, sheep, goats, horses).

Behavioural signs of poisoning are general restlessness and skin irritation. Restlessness is often indicated by pawing of the ground, head shaking, head rubbing, and occasional hindlimb weakness with knuckling over, panting, confusion and depression. Mania and hyperactivity may also result including running in circles until exhausted. Observations of thick wort infestations by Australian graziers include the appearance of circular patches giving hillsides a ‘crop circle’ appearance, possibly from this phenomenon. Animals typically seek shade and have reduced appetite. Hypersensitivity to water has been noted, and convulsions may occur following a knock to the head. Although general aversion to water is noted, some may seek water for relief.

Severe skin irritation is physically apparent, with reddening of non-pigmented and unprotected areas. This subsequently leads to itch and rubbing, followed by further inflammation, exudation and scab formation. Lesions and inflammation that occur are said to resemble the conditions seen in foot and mouth disease. Sheep have been observed to have face swelling, dermatitis, and wool falling off due to rubbing. Lactating animals may cease or have reduced milk production, pregnant animals may abort. Lesions on udders are often apparent. Horses may show signs of anorexia, depression (with a comatose state), dilated pupils, and injected conjunctiva.

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