Hypericum perforatum

Hypericum perforatum, better known as St. John's wort, is a perennial flowering plant native to continental Europe. It is used, primarily, to treat depression, especially mild-moderate cases of depression. Most physicians and pharmacists will advise its use solely in mild-moderate cases of depression, although a recent (2010) National Institute for Health and Care Excellence textbook on depression found it was effective in moderate-severe cases too.[1]:390-391 There are a number of potentially serious interactions with other drugs, as it interferes with their metabolism in the liver and can increase serotonin levels, which means it is taken along with other medicines with a similar action on serotonin it can lead to serotonin syndrome. It is believed to produce its effects via hyperforin, a compound that non-competitively (that is, it does not bind directly to the transporter proteins) inhibits the reuptake of various neurotransmitters include serotonin, noradrenaline, dopamine, gamma-aminobutyric acid and glutamate.[2]

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  1. National Collaborating Centre for Mental Health (2010). Depression: the NICE guideline on the treatment and management of depression in adults (PDF) (Updated ed. ed.). London, UK: Royal College of Psychiatrists. ISBN 978-1-904671-85-5. PMID 22132433. 
  2. Russo, E; Scicchitano, F; Whalley, BJ; Mazzitello, C; Ciriaco, M; Esposito, S; Patanè, M; Upton, R; Pugliese, M; Chimirri, S; Mammì, M; Palleria, C; De Sarro, G (May 2014). "Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions.". Phytotherapy Research 28 (5): 643–55. PMID 23897801. doi:10.1002/ptr.5050.