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Consumer use of St. John's wort: a
survey on effectiveness, safety, and
tolerability.
Beckman SE, Sommi RW, Switzer
J.
Department of Psychiatry, School of Pharmacy, University
of Missouri-Kansas City, and Western Missouri Mental Health Center,
64108-2792, USA.
Despite its poorly described pharmacology,
effectiveness, and safety, use of St. John's wort (SJW) is largely
unsupervised and unexplored, and can potentially lead to adverse
outcomes. We conducted a telephone survey of 43 subjects who had taken
SJW to assess demographics, psychiatric and medical conditions, dosage,
duration of use, reason for use, side effects, concomitant drugs,
professional consultation, effectiveness, relapse, and withdrawal
effects. Most subjects reported taking SJW for depression, and 74% did
not seek medical advice. Mean dosage was 475.6+/-360 mg/day (range
300-1200 mg/day) and mean duration of therapy was 7.3+/-10.1 weeks
(range 1 day-5 yrs). Among 36 (84%) reporting improvement, 18 (50%) had
a psychiatric diagnosis. Twenty (47%) reported side effects, resulting
in discontinuation in five (12%) and one emergency room visit. Two
consumers experienced symptoms of serotonin syndrome and three reported
food-drug interactions. Thirteen consumers experienced withdrawal
symptoms and two had a depressive relapse. These data suggest the need
for greater consumer and provider awareness of the potential risks of
SJW in self-care of depression and related syndromes.
PMID:
10809344 [PubMed - indexed for MEDLINE]
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