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From: Brian Symonds <[log in to unmask]> A person with PD asked me about using St. John's Wort for depression, so I dug up some info on it that I believe is accurate. Hypericum perforatum is an aromatic perennial herb, producing yellow flowers in June, and since June 24th is the day traditionally celebrated as the birthday of John the Baptist, the plant is commonly known as St. John's Wort (wort is a suffix meaning plant). St. John's Wort was known to ancient authorities of medicinal plants such as Hippocrates, and is described and recommended as a useful remedy in herbal books since that time. Recently, Europeans have "discovered" that a tea prepared from the herb (leaves and flowers are harvested) is an effective "nerve tonic", and its use is promoted for anxiety and depression. It has also been promoted as a diuretic (water pill type medication), and in the treatment of various conditions ranging from insomnia to gastritis. An olive oil extract of the fresh flowers acquires a reddish colour after standing in sunlight for several weeks, and is promoted for internal use for the same conditions as the tea, but is also promoted to be applied externally to relieve inflammation and promote healing, one such use being the treatment of hemorrhoids. There have been chemical investigations of St. John's Wort. It is 10% tannin, a compound that has astringent and protein-precipitation actions, and accounts for its anti-inflammatory effect. Its antidepressant effects are due to various contained xanthones and flavonoids that act as "monoamine oxidase inhibitors" or MAOIs. In medicine, MAOIs have generally not been used as the first choice for antidepressant medications because of their many and potentially fatal side effects, especially because of their potential interaction with many over the counter medications (such as cough and cold preparations), and chemicals found in a variety of foods (such as red wines, beer including non-alcoholic beer, some cheeses, some fruits, some processed meats, etc). The antidepressant activity of St. John's Wort was initially thought to be due to the presence of hypericin, a reddish dianthrone pigment, but it is now known that this is not the case. Unfortunately, this compound can induce a "photosensitivity" of the skin characterised by dermatitis of the skin and inflammation of the mucous membranes (especially the mouth) on exposure to direct sunlight (the reaction apparently looks like a poison ivy type allergic reaction or a shingles type of rash, and is quite uncomfortable). This does not usually happen with normal doses of St. John's Wort when taken over short periods of time. Those who take the herb for extended periods are more at risk. A newer pure MAOI is called Manerix (Moclobemide), and it is free of many of the potential interactions and is safer to use than the older types of MAO inhibitors. It is a monoamineoxidase-A inhibitor, and inhibits the deamination of serotonin (Prozac by the way also acts by increaseing serotonin levels in the brain although through a different mechanism), norepinephrine, and dopamine, thus increaseing their levels in the brain, all of which are neurotransmitters, and all of which are involved in depression and anxiety states. St. John's Wort is generally safe when taken in small amounts, for relatively short times, if you are not taking any other medications (prescription or over the counter), and if you do not suffer from heart disease, high blood pressure, have risk of stroke, liver disease, seizure disorders, Parkinson's Disease, Diabetes, kidney disease, or thyroid diseases. It should not be taken in pregnancy, especially the first 14 weeks. You should remember that it is a mixture of chemicals, and can have potentially serious and even fatal side effects. If you are using this (or any other herbal or over the counter medication), you should always inform your doctor.