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of the cited studies, but because of the many different preparations of Saint John’s wort,
dosages are not truly comparable. Lake and Spiegel and Brown et al. II (through Sarris, J.)
recommend dosages of 300 mg three times per day. In the absence of a standardized
formulation, dosages can only be considered as approximations.- RESEARCH: Long-term outcomes -- benefits and liabilities from continuing treatment with
St. John’s wort and comparative assessment with other drugs -- require further
investigation, as do the systematic tracking, reporting and quantification of adverse effects.
1
Linde, K., Ramirez, G., Mulrow, C., Pauls, A., Weidenheimer, W., & Melchart, D., “St. John’s Wort for Depression –
An Overview and Meta-analysis of Randomized Clinical Trials,” British Medical Journal 313(7052):253-258 (1996).
(^2) “Dietary Supplements and Natural Products as Psychotherapeutic Agents,” by Adriane Fugh-Berman, M.D. (of
Georgetown Medical School) and Jerry M. Cott, Ph.D. (of the National Institutes of Health) (1999), Psychosomatic
Medicine 61:712-728 (1999) at 713.
(^3) How to Use Herbs, Nutrients & Yoga in Mental Health Care, by Richard P. Brown, M.D. (of Columbia University
College of Physicians and Surgeons), Patricia L. Gerbarg, M.D. (of New York Medical College), and Philip R. Muskin,
M.D. (of Columbia as well) (W. W. Norton and Company, New York, 2009) at 33.
(^4) Nierenberg, A.A., Lund, H.G. & Mischoulon, D., “St. John’s Wort: A Critical Evaluation of the Evidence for
Antidepressant Effects,” in Natural Medications for Psychiatric Disorders: Considering the Alternatives, co-edited by
David Mischoulon, M.D. and Jerrold F. Rosenbaum, M.D. (both of Harvard Medical School) (Lippincott, Williams
and Wilkins, Philadelphia 2002/2008) at 35.
(^5) Id.
(^6) Lake, J.A. and Spiegel, D., Complementary and Alternative Treatments in Mental Health Care, American
Psychiatric Publishing, Inc., Washington (2007), at 97.
(^7) Natural Standard Herb and Supplement Guide: An Evidence-based Reference, “St. Johns wort,” at 684-686.
(^8) Berkeley (University of California) Wellness Reports – Dietary Supplements (2010 and 2011 editions), “St. John’s
wort” at 51/51.
(^9) Consumer Reports, “Dangerous Supplements,” published by Consumers Union, September, 2010 at 16-20.
(^10) The Mayo Clinic Guide to Alternative Medicine 2011 (Time Home Entertainment, Inc., New York 2010) at 60.
(^11) http://nccam.nih.gov/health/providers/digest/depression-science?nav=cd