Synopsis

Source of validity: Scientific
Rating (out of 5): 2

St. John’s Wort (Hypericum perforatum) has a long history of traditional use for mood-related disorders, primarily mild to moderate depression. Its application for anxiety disorders is less well established, but there is some scientific inquiry into its effects on anxiety symptoms. The active compounds in St. John’s Wort, such as hypericin and hyperforin, are believed to influence neurotransmitters like serotonin, dopamine, and norepinephrine, which are relevant to both depression and anxiety.

Clinical evidence specifically for anxiety is limited compared to its use in depression. Some smaller randomized controlled trials and open-label studies have suggested potential benefits for individuals with generalized anxiety disorder (GAD) or mixed anxiety and depressive symptoms. However, high-quality, large-scale studies focusing solely on anxiety are lacking. Systematic reviews and meta-analyses generally conclude that while St. John’s Wort is more reliably effective for depression, the evidence for anxiety is inconsistent or insufficient to recommend its use as a first-line therapy.

Additionally, St. John’s Wort is associated with significant drug interactions, particularly with medications metabolized by the cytochrome P450 system, which limits its safety and utility. In summary, while there is some scientific rationale and limited evidence for its use in anxiety disorders, the overall quality and quantity of the supporting data are not strong, leading to a moderate-to-low evidence rating.

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