Can St John’s Wort be taken with melatonin? (3 tips)

This article will explore whether Saint John’s Wort and melatonin can be taken together. It will discuss the overlapping side effects between SJW and melatonin and mention people who are at the highest risk of interaction between the two.

Moreover, the article will provide suggestions on how to choose between taking either Saint John’s Wort or melatonin. Finally, it mentions some tips that may be helpful if you take them together.

Can St John’s Wort be taken with melatonin?

Saint John’s Wort (SJW) can be taken with melatonin, but this is highly unrecommended. SJW is a medicinal herb that improves mood and treats depression. It also helps in treating viral infections, enhances the actions of certain antibiotics against resistant organisms, and helps with wound healing [1].

Melatonin, on the other hand, is a supplement that enhances sleep quality and is useful for people suffering from insomnia [2]. Both SJW and melatonin can cause daytime drowsiness, sedation, decreased cognition, and decreased attentiveness. Thus, it is recommended not to combine them.

Similarly, other drugs that may cause sedation, like trazodone or Benadryl, may cause these interactions if taken with melatonin.

If you are thinking about taking Saint John’s wort, melatonin, or a combination of both, you should consult your doctor first. They will assess your medical and medication history and recommend the appropriate option for you.

What are the side effects of taking SJW and melatonin?

The table below illustrates the side effects of St John’s Wort and melatonin [2,3]:

What are the interactions between SJW and melatonin?

The table inserted earlier shows that there are multiple common and overlapping side effects between Saint John’s Wort and melatonin. The most important interactions between them are the risk of sedation and daytime drowsiness. 

Both of these drugs help reduce the stimulation of the central nervous system. Thus, while they may help people sleep better, they may also decrease their ability to concentrate and be attentive during the day. This is dangerous as it may affect one’s productivity, lead to falls in the elderly, or cause accidents. 

Other less serious interactions include an increased risk of headaches and GI side effects. These side effects are usually tolerable when caused by either SJW alone or melatonin alone.

However, combining them may increase the occurrence and severity of these side effects, making them undesirable and intolerable for some people.

Who is at risk of interactions between SJW and melatonin?

People respond to medications, herbs, and supplements differently, and not everyone will experience the same interaction between St. John’s Wort and melatonin. Additionally, people who experience these interactions won’t be equally affected by them.

For instance, this combination is most dangerous for the elderly. To illustrate, older people are at higher risk of falling. Moreover, falling is more serious and life-threatening in the elderly than in other people; they are more likely to suffer from fractures and injuries, which may severely affect their quality of life.

The combined sedation and disorientation side effects of SJW and melatonin increase the chance of falls in older people. Moreover, people who work in factories or engage in dangerous physical activities that require attentiveness or concentration shouldn’t take this combination as well.

Furthermore, it is advisable for people who have an important exam or a test not to take SJW and melatonin together. Taking them may decrease concentration and attentiveness, which can negatively impact one’s performance on a test. 

It is also risky for people who drive vehicles to take this combination, as it may increase the risk of accidents. In addition, people with a history of headaches or migraines, or those with gastrointestinal conditions like IBS, may experience increased and intolerable headaches and DI side effects.

Should you take St. Jaint Worts or melatonin?

The decision between taking SJW or melatonin should be made by a healthcare professional; they will assess your medical and medication history and determine the appropriate approach accordingly. 

For example, if your main complaint is depression or mood disorders, the doctor will probably recommend Saint John’s Wort. On the other hand, if you only want to take something that will help you sleep, then melatonin is more suitable.

However, if you are suffering from depression for which you are already taking antidepressants, you should not take Saint John’s Wort. This may lead to serotonin syndrome, which is very dangerous. Thus, avoid taking SJW with serotonergic antidepressants such as sertraline and Celexa.

In this case, it is better to take melatonin for your sleep disturbances.

Additionally, if you take drugs that are CYP3A4 substrates, like digoxin, theophylline, ivabradine, warfarin, or certain anticancer drugs, you must not take SJW. This herb increases the breakdown of these drugs and decreases their activity.

Thus, it is important to inform your doctor about your medications to help them choose the most suitable supplement for you. It is also better to avoid Saint John’s Wort if you have kidney or liver disease or photosensitivity. In this case, taking melatonin is preferable.

What to do if you take SJW and melatonin together?

It is okay if you take Saint John’s Wort and melatonin together. After all, Saint John’s Wort is a herb and melatonin is a supplement; they are less potent and less likely to cause serious problems than prescription sedatives and hypnotics.

You may need to drink a cup of coffee or tea to avoid daytime sleepiness. If you do experience sedation, disorientation, or dizziness during the day after taking them together, you should avoid driving or engaging in dangerous sports or activities.

Furthermore, elders who take this combination may need supervision. It is recommended for someone to be present to monitor their balance and movement and help prevent falls.

Understanding the effects of combining SJW and melatonin

From my perspective, Saint John’s Wort and melatonin can be combined. However, I don’t recommend taking them together unless this is prescribed by a doctor.

Based on my knowledge, taking SJW and melatonin together may increase the likelihood of daytime drowsiness and sedation. It may also decrease cognition, concentration, and attentiveness, and increase GI discomfort and headaches.

I believe that combining SJW and melatonin is most dangerous for the elderly or people who drive, work on dangerous machinery, or engage in dangerous sports. I also believe that these supplements shouldn’t be taken together before an important test to avoid decreased concentration and bad performance.

If you are thinking about taking St. John’s Wort, melatonin, or both of them, I recommend consulting with a doctor first. You should tell them about your other medications and the condition you want to take them for so that they can determine which one is more suitable for you. 

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