Adverse effects profile of the herbal antidepressant St. John's wort (Hypericum perforatum L.).
This paper provides a systematic review of adverse drug reactions (ADRs) associated with the use of extracts of the herb St. John's wort (Hypericum perfbratum L.) for the treatment of mild to moderate depression.


METHODS
Searches of four computerized literature databases were performed for records of (ADRs). Manufacturers of hypericum products, the international drug monitoring centre of the World Health Organization (WHO) and the national drug safety monitoring bodies of Germany and the United Kingdom were also contacted for information.


RESULTS
Information on (ADRs) originates from case reports, clinical trials, post-marketing surveillance and drug monitoring studies. Collectively, the data suggest that hypericum is well tolerated, with an incidence of adverse reactions similar to that of placebo. The most common adverse effects are gastrointestinal symptoms, dizziness/confusion and tiredness/sedation. A potential serious adverse effect is photosensitivity, but this appears to occur extremely rarely.


CONCLUSIONS
Hypericum has an encouraging safety profile. However, as most of the current data originate from short-term investigations, more long-term studies are desirable.
Ernst
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E
Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, Devon, UK. E.Ernst@exeter.ac.uk
Rand
J I
JI
Barnes
J
J
Stevinson
C
C
D000928:Antidepressive Agents / Q000009:adverse effects*; D016903:Drug Monitoring; D020448:Ericales / Q000009:adverse effects*; D006801:Humans; D017319:Photosensitizing Agents / Q000009:adverse effects*; D010936:Plant Extracts / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic
D000928:Antidepressive Agents; D017319:Photosensitizing Agents; D010936:Plant Extracts