Can St John’s Wort cause panic attacks? (3+ factors)

This article will discuss whether Saint John’s Wort can cause panic attacks. It will explain the possible mechanism by which it can cause this side effect and will explore cases that report panic attacks as a side effect of Saint John’s Wort.

The article will additionally mention factors that influence the risk of Saint John’s Wort-induced panic attacks. It will also provide suggestions on what to do if Saint John’s Wort causes panic attacks.

Can St John’s Wort cause panic attacks?

Yes, Saint John’s Wort (SJW) can cause panic attacks. However, this is very rare, and it is more likely to occur in people who already have risk factors for panic attacks. There aren’t any studies that discuss SJW’s ability to cause panic attacks.

However, people respond to medications differently, and while most people don’t experience panic attacks while taking St John’s Wort, it is important to consider that some people do. Thus, if you suffer from SJW-induced panic attacks, you must talk to a doctor.

How can St John’s Wort cause panic attacks?

The exact mechanism by which Saint John’s wort can cause panic attacks is not well studied and understood. However, it is suggested that panic attacks occur due to an imbalance in neurotransmitters.

Research suggests elevated serotonin leads to disruptions in the fear network model of the autonomic nervous system. On the other hand, St John’s wort is a nonselective reuptake inhibitor of serotonin, norepinephrine, and dopamine. Thus, it increases serotonin, which can cause panic attacks [1, 2].

What does research suggest?

A patient was presented to the hospital suffering from excessive panicking and fear of dying two hours after drinking a glass of St John’s wort extract. His other symptoms included restlessness, anxiousness, tachycardia, anxiety, excessive sweating, chest pain, and shortness of breath.

The doctors assessed his symptoms and found he meets the diagnostic criteria for panic attacks. He didn’t have any personal or family histories of anxiety or panic attacks. The doctor stated that St John’s Wort was the probable cause for his panic attacks [3].

What factors influence SJW-induced panic attacks?

Multiple factors can increase the likelihood of experiencing panic attacks while taking St John’s Wort. For example, people with high sensitivity to drugs or medicinal plants are more likely to suffer from this side effect.

Moreover, this is more likely to occur in people who started with a high dose of SJW or in those who jump to high doses without applying proper dose titration. People who consume large amounts of caffeine and nicotine are also at higher risk of getting SJW-related panic attacks.

The table below demonstrates the conditions and medications that can influence SJW-induced panic attacks [2]:

What to do if you experience panic attacks while taking SJW?

If you experience panic attacks while taking Saint John’s Wort, you must report this to your doctor. They will assess your symptoms and medical history to determine the actual cause of your condition. If they find that SJW is causing your panic attacks, they may reduce the dose and monitor your response.

If you still get SJW-induced panic attacks despite the dose adjustments, the doctor will most likely recommend discontinuing this herb. They may prescribe additional medications for managing panic attacks, such as benzodiazepines or antidepressants like fluoxetine, Lexapro, sertraline, and Effexor.

Furthermore, it is recommended that you avoid smoking, consuming caffeine, or consuming alcohol.

Understanding the link between St John’s Wort and panic attacks

Based on my research, I concluded that it is very rare for Saint John’s Wort to cause panic attacks. I also found that there is only one case reporting panic attacks as a side effect of Saint John’s Wort. Moreover, I didn’t find any evidence about the possible mechanism by which SJW can cause panic attacks.

However, I believe that SJW’s ability to increase serotonin may be the reason why it can cause panic attacks. Based on my knowledge, people who take high doses of SJW, or those who smoke, drink lots of alcohol, or consume a lot of caffeine, are most likely to experience this side effect.

From my perspective, diseases like hyperthyroidism, social anxiety, panic disorder, and vestibular dysfunction, or medications like opioids and certain antidepressants, increase the risk of SJW-induced panic attacks.

If you experience panic attacks while taking Saint John’s Wort, I recommend consulting with a doctor. They will assess your condition and recommend a course of action accordingly. The doctor will most likely suggest taking a lower dose or stopping this herb altogether.

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