Does St John’s Wort increase serotonin? (benefits vs risks)

This article will discuss whether Siant John’s Wort increases serotonin levels. The article will examine research findings on this topic. It will also mention the benefits and risks of increased serotonin levels caused by St. John’s Wort. 

Finally, the article will discuss important factors to consider before taking St. John’s Wort and mention alternative herbs, foods, and drugs that increase serotonin.

Does St John’s Wort increase serotonin?

Yes, Saint John’s Wort increases serotonin. It is a non-selective reuptake inhibitor that inhibits the reuptake of serotonin, dopamine, GABA, and norepinephrine. As a result of its actions on these neurotransmitters, it can be used as a hypnotic and anti-depressant [1].

St. John’s Wort-induced increased serotonin makes it beneficial for treating depressive symptoms. However, this increase in serotonin can lead to various problems, especially if taken with another serotonergic antidepressant.

Thus, it is advisable to consult with a doctor before taking St. John’s Wort for depression. They will assess your concurrent medications to determine the risk of drug interactions and choose an appropriate treatment plan.

What does research suggest?

Multiple studies were conducted to understand the mechanism by which St. John’s wort treats depression. For instance, biochemical studies have reported that hypericin and hyperforin inhibit the uptake of serotonin into the neurons.

In addition, in vivo trials also suggested that St. John’s wort extract causes an upregulation of serotonin receptors in the frontal cortex of rats. Other investigations also found increased serotonin concentrations in the rats’ brains [1].

Furthermore, a meta-analysis reviewed the findings of 27 clinical trials that compared St. John’s Wort’s efficacy and safety to select serotonin reuptake inhibitors [2].

Accordingly, it was found that St. John’s wort’s response and remission rates were similar to those of SSRIs, and patients taking SJW were less likely to discontinue their treatment [2].

What are SJW’s actions other than increasing serotonin?

While Saint John’s Wort is known for inhibiting the reuptake of serotonin and other neurotransmitters and increasing their levels, contributing to its efficacy in treating depression and anxiety and enhancing mood, it also has multiple other actions and effects on the body.

Some of these actions are mentioned below:

• Saint John’s Wort can help treat certain viral infections, such as varicella Zoster virus and HIV. Ashwagandha is another herb that can be added to enhance immunity and help with infections.

• SJW can also help with bacterial infections, especially MRSA and PRSA infections, because it enhances the actions of certain antibiotics.

• SJW has anti-inflammatory and wound-healing effects; it can help with eczema and herpetic lesions.

What are the side effects of SJW’s impact on serotonin?

Saint John’s Wort can cause some side effects, but it is generally considered a safe drug and has a good safety profile. Its side effects are demonstrated in the following table [3]:

Can Saint John’s Wort cause serotonin syndrome?

Saint John’s Wort can cause serotonin syndrome, especially if taken with other antidepressants or certain botanicals. Thus, it is advisable to avoid taking SJW with antidepressants like Celexa or sertraline. SJW monotherapy can cause serotonin syndrome as well.

There is a case report of a 40-year-old man who experienced serotonin syndrome after taking St. John’s wort alone. However, this patient had a history of SSRI-related mania, which means that he already has a high sensitivity to drugs and their side effects.

There is another case of a woman who experienced serotonin syndrome upon taking SJW with kava kava and valerian root, which are other botanicals that have hypnotic and anxiolytic effects. Furthermore, combining St. John’s Wort with other antidepressants led to serotonin syndrome in multiple case reports.

Serotonin syndrome is a very dangerous situation, as it may cause disorientation, seizures, a fast heart rate, elevated blood pressure, difficulty breathing, increased sweating, and nausea. In fact, this condition can be life-threatening sometimes.

Considerations before taking Saint John’s Wort for depression

If you’re thinking about taking Saint John’s Wort for depression, multiple factors should be considered:

• It is recommended to start with low doses of SJW, especially if you’re taking it for the first time. You can then gradually increase its dosage if needed, under the supervision of a doctor.

• SJW interacts with certain drugs, including benzodiazepines, digoxin, warfarin, immunosuppressants, and theophylline. It increases their breakdown and reduces their effectiveness. Thus, you shouldn’t take it if you’re taking any of these drugs.

• Saint John’s Wort also increases the metabolism of oral contraceptives and decreases their actions, which may lead to an unplanned pregnancy. Thus, it shouldn’t be taken with oral contraceptives.

• While this herb has a good safety profile, it is still necessary to consult with a doctor before taking it, as it may interact with your other medications or cause serotonin syndrome.

What other drugs increase serotonin?

If Saint John’s wort isn’t suitable for you, interacts with your medications, or causes intolerable side effects, multiple other herbs, foods, and medications can be administered to increase serotonin. Other serotonin-increasing herbs and foods include oregano, thyme, curcumin, grapes, tea, and cocoa beans [4].

Drugs that increase serotonin include trazodone, SSRIs like citalopram, sertraline, paroxetine, fluvoxamine, and fluoxetine, or SNRIs like duloxetine or venlafaxine. However, you must consult with a doctor before taking these prescription drugs.

Understanding St. John’s Wort’s effects on serotonin levels

Based on my knowledge, Saint John’s Wort increases the action of serotonin by inhibiting its reuptake in the cells and increasing its availability in the synapse. This mechanism contributes to its efficacy in managing depressive symptoms and enhancing mood.

From my perspective, it is important to be aware that Saint John’s effect on serotonin can also lead to side effects, such as serotonin syndrome. This is a very dangerous condition, and it is most likely to occur in people who are taking another drug that increases serotonin.

Thus, I believe that it is necessary to consult with a doctor before using SJW for its effects on serotonin, especially if you’re using oral contraceptives, taking other antidepressants, or administering other drugs like digoxin, warfarin, theophylline, cyclosporins, or benzodiazepines.

References