St. John's Wort
Hypericum perforatum
A Strong clinical evidenceSt John's wort extract may help with mild to moderate depressive episodes, but it seriously interacts with many medicines, including the pill.
Image: Herbadex Botanik Stüdyosu · Özel Üretim
On this page
At a glance
The EMA classes standardised dry extracts of St John's wort as "well-established use" for mild to moderate depressive episodes; depression must be diagnosed and followed by a doctor. Its tea rests on traditional use for temporary mental exhaustion, mild stomach discomfort and difficulty falling asleep. Because it induces liver enzymes, it changes the effect of many medicines, especially the contraceptive pill, blood thinners and antidepressants.
Updated: October 15, 2026
✓ This herb record is backed by official European Medicines Agency (EMA HMPC) herbal monographs.
What is it used for?
A Strong clinical evidence
Strong clinical evidence: Supported by strong human clinical trials and well-established medicinal use monographs.
How do we rate evidence levels? →Standardised dry extracts may help with mild to moderate depressive episodes, under a doctor's care. [1]
T Traditional use
Traditional use: Based on at least 30 years of documented traditional use rather than clinical trials.
How do we rate evidence levels? →Its tea is traditionally used for temporary mental exhaustion and for restlessness with difficulty falling asleep. [1]
T Traditional use
Traditional use: Based on at least 30 years of documented traditional use rather than clinical trials.
How do we rate evidence levels? →Its tea is traditionally used for mild stomach and gut discomfort. [1]
How is it used?
Tea
Pour 150 ml of boiling water over 1.5–2 g of chopped herb.
Amount: 2–3 times daily
Duration limit: See a doctor if no better after 2 weeks
[1]Food
For depressive episodes, use only a standardised extract product recommended by a doctor.
Amount: As on the product label
Duration limit: Effect begins within 4 weeks
[1]Safety & interactions
Minimum age: 18 years
- If you take prescription medicines, always ask a doctor or pharmacist before starting.
- Avoid intense sun or sunbeds; fair-skinned people may get sunburn-like reactions.
- Before planned surgery, tell your doctor because of possible interactions with anaesthetics.
- Not recommended under 18, in pregnancy or while breastfeeding.
Drug interactions
| Medicine / substance | Effect | Severity |
|---|---|---|
| Birth control pills and other hormonal contraceptives | Lowers their levels and can cause breakthrough bleeding and reduced protection; use an extra method. [1] | Major |
| Coumarin anticoagulants (e.g. warfarin), ciclosporin, tacrolimus, everolimus, sirolimus | Lowers their blood levels; combined use is contraindicated. [1] | Major |
| HIV medicines (protease inhibitors, nucleoside reverse transcriptase inhibitors) and some cancer drugs (e.g. irinotecan, imatinib) | Reduces their effect; combined use is contraindicated. [1] | Major |
| Antidepressants (e.g. sertraline, paroxetine) and buspirone | Risk of serotonin syndrome (sweating, fast heartbeat, fever, agitation, tremor); do not combine. [1] | Major |
| Alprazolam, diazepam, midazolam, methadone, simvastatin, digoxin, amitriptyline and other drugs broken down by CYP enzymes | Their levels may fall; ask a doctor first if you take prescription medicines. [1] | Moderate |
Side effects
- Nausea, abdominal pain, diarrhoea
- Allergic skin reactions
- Tiredness, restlessness
- Tingling, burning or sunburn-like symptoms in intense sunlight
⚕ When to see a doctor
- If high fever, shortness of breath or purulent/bloody phlegm develops
- If symptoms do not improve within 1–2 weeks or worsen
- If severe abdominal pain, jaundice, rash or allergic reaction occurs
Did you know?
The EMA accepts St John's wort for depression only as standardised extracts recommended by a doctor. [1]
Frequently asked questions
Does St John's wort reduce the effect of the pill?
Yes. According to the EMA, St John's wort can lower hormonal contraceptive levels and reduce protection; use an extra method.
Can I take St John's wort with antidepressants?
No. With antidepressants such as sertraline or paroxetine there is a risk of serotonin syndrome.
Does St John's wort help depression?
Based on clinical studies, the EMA accepts that standardised extracts may help with mild to moderate depressive episodes. Depression needs a doctor's care.
How do I make St John's wort tea?
Pour 150 ml of boiling water over 1.5–2 g of chopped herb; drink 2–3 times a day. Ask a doctor first if you take medicines.
Sources
Cite This Page
St. John's Wort (Hypericum perforatum). Herbadex — Doğal Şifa Rehberi (2026). https://herbadex.com/en/herb/st-johns-wort/
Related guides and comparisons
Related plant and preparations
Related herbs
Lemon Balm
T Traditional useMelissa officinalis
Lemon balm leaf tea is traditionally used to relieve mild symptoms of stress, to aid sleep and for mild bloating and wind in adults.
Basil
T Traditional useOcimum basilicum
An aromatic culinary herb. Traditionally used for indigestion and wind; calming effects have only been seen in animal studies.
Valerian Root
A Strong clinical evidenceValeriana officinalis
Dry extracts of valerian root may help with mild nervous tension and sleep problems; they work gradually, so use them for 2–4 weeks.
Saffron
B Limited clinical evidenceCrocus sativus
The world's most expensive spice. Meta-analyses found 30 mg of saffron extract daily helped mild-to-moderate depression symptoms.
Rose Oil
B Limited clinical evidenceRosa damascena
Distilled from Damask roses, one of the world's most precious essential oils. Small aromatherapy studies suggest it may help ease anxiety.
Hawthorn
T Traditional useCrataegus spp.
Hawthorn leaf and flower are traditionally used for palpitations linked to mild anxiety, after a doctor has ruled out serious heart disease.
Other herbs in the same preparation form (Dried Herb & Tea)
Dried Herb & Tea →
Echinacea
A Strong clinical evidenceEchinacea purpurea
Juice pressed from fresh echinacea plants may help with short-term prevention and treatment of colds. Dried echinacea tea is not covered.
Psyllium Husk
A Strong clinical evidencePlantago ovata
Taken with plenty of water, psyllium husk helps soften stools in constipation; keep a gap between it and other medicines.
Senna
A Strong clinical evidenceSenna alexandrina
A stimulant laxative for short-term relief of occasional constipation. No longer than 1 week; not for children under 12, in pregnancy or while breastfeeding.
Ginkgo Leaf
A Strong clinical evidenceGinkgo biloba
Standardised ginkgo extract may help age-related cognitive decline and mild dementia; bleeding risk and interactions call for caution.
