Kelly's St. John's Wort pages for depression since 1997
General Cautions to consider
Please read the side-effects section before this one.
These are some general and in some cases common-sense cautions in taking St. John's Wort. I could not possibly think of absolutely everything here, but you may find the words below to be good advice anyway, so long as you have read the side-effects page first to see which if any of those may apply to you.
If you are pregant or nursing, please do not take St. John's Wort (if possible.)
Honestly, I have no medical basis for saying this other than I don't believe there are any studies done on the effects of St. John's Wort and an unborn child. The brand I've been buying recently has a warning that you should not take St. John's Wort while pregnant, so enough said. That's true of all other antidepressants that I know of as well, though for some people it's a life-or-death choice and therefore they must continue on anyway. As for breastfeeding, I think there's still not enough known about St. John's Wort to say if it's safe or not, so if at all possible you should avoid taking it while breastfeeding. Again, I don't have all the answers but I think you are better safe than sorry. Talk to your doctor.
If you are taking heart medication, consult your doctor!
I would hope this goes without saying. You need to get an expert medical opinion on any and all drugs you combine with heart medication.
If you are on birth control pills...
SJW may interact with birth control pills, but it's not scientifically proven yet. Read what I wrote in the "side-effects" section and follow the link provided to read the official press release that has spawned the debate.
If you are currently taking other antidepressants besides the SSRI-based ones...
If you are taking multiple antidepressants as prescribed by your doctor, or suffer from more severe types of depression, please do not stop taking them all in order to take St. John's Wort. SJW is not a wonder drug, though it's an absolutely excellent alternative to prescription SSRI-based drugs. I would hope this goes without saying as well, but let me state this loud and clear: St. John's Wort has been used in place of other SSRI drugs, it is NOT INTENDED TO REPLACE lithium, tricyclics, specific panic/anxiety drugs (outside of SSRIs), and whatever else. Plus, you should never *abruptly* switch from one medication to another, even if it is St. John's Wort, as the change will likely cause depression -- see the next section. Please consult your doctor before taking your life into your own hands (some people can not function normally without these daily medications.)
Avoid light therapies (for Seasonal Affective Disorder) and too much sunlight!!
This is per my caution in the side-effects section on potential long-term damage to your eyes due to your increased sensitivity to sunlight. If you are doing light therapy treatments, you need to consult your doctor and find an antidepressant that does *not* increase your sensitivity to sunlight. If you need to get that tan by the beach, stop taking SJW at let it fully get out of your body before you do so. Stay safe!
Do not mix SJW with other anti-depressants
It is not well-known what sort of interactions you might experience by combining different drugs that do essentially the same thing. My thoughts are that you should find a drug for depression that works for you and take only that. I would not recommend that you combine SJW with others like Prozac, Paxil, Zoloft, Serzone, etc. One person on my message forum was told by her pharmacist that taking Zoloft and SJW together can be fatal but I have not seen this report at all. However, it is worth putting up the caution here in case it is true.
What foods should I avoid?
"Is St. John's Wort a 'MAOI'?"
Wait, relax for a minute. There has been much debate in this area recently, as it was believed that St. John's Wort exhibits MAOI traits. What is a MAOI? If you really want to know, you should research some medical sites elsewhere.
Here is an introduction: there are some types of antidepressants that can be very effective but also make your body react *severely* with certain foods such as red wine, aged cheeses, sausage, etc -- and that failing to avoid these foods could cause serious health problems and even death.. The original thought was that St. John's Wort is a MAOI too. If this is true in the strictest sense, I would be dead. I, for one, consume many of the above foods on a regular basis and have done so for over three years, as of April 2000.
It's now believed that St. John's Wort does exhibit *very weak* MAOI properties even though it is not technically a MAOI. The fact that hundreds of thousands of people take St. John's Wort and that I've never heard of anyone dying from it (or any kind of major complication from it) should be very reassuring. I don't think the same can be said of any prescription antidepressants. And, of course there is much misinformation floating around.
If you are still concerned about this, consult your doctor and get his medical opinion. And have your blood pressure checked before and a few weeks after you start taking St. John's Wort. When in doubt, play it safe. And don't say, "I heard it on the web..."