St John's Wort (amber, amber touch and teal, balm-of-warrior's wound, balsana, demon chaser, devil's scourge, goatweed, hypericin, hypericum perforatum, Johanniskraut, klamath weed, millepertuis, rosin rose, tipton weed, walpurgiskraut, witcher's herb)
Classes: Neurology & Psychiatry, Herbals
Suggested dosing of amber, amber touch and teal (St John's Wort)
Depression, Mild-moderate
Hypericin 0.3% standardized extract
- 300 mg PO TID, OR
- 1200 mg PO qDay
Hypericin 0.2% standardized extract: 250 mg PO BId
Hyperforin 5% standardized extract: 300 mg PO TId
Crude: 2-4 g PO qDay-TId
Obsessive-compulsive Disorder
Hypericin 0.3% standardized extract (XR): 450 mg PO BId
Premenstrual Syndrome
Hypericin 0.3% standardized extract: 300 mg PO qDay
Glioblastoma Multiforme (Orphan)
Orphan indication sponsor
- Nexell Therapeutics, Inc; 2751 Centerville Rd., Suite 210; Wilmington, DE 19808
Cutaneous T-Cell Lymphoma (Orphan)
Orphan indication sponsor
- Nexell Therapeutics, Inc; 2751 Centerville Rd., Suite 210; Wilmington, DE 19808
Other Information
No more than 8 weeks of use
Avoid abrupt discontinuation due to withdrawaL
Suggested uses of amber, amber touch and teal (St John's Wort)
Oral: Depression (mild-moderate), psychosomatic disorder, obsessive-compulsive disorder, anxiety, premenstrual syndrome, burning mouth syndrome, neuropathy
Topical: atopic dermatitis, wound healing
Efficacy
Although controversy exists, available evidence suggests that for depression more effective than placebo & may be as effective as standard antidepressants with less side effects (Cochrane Review 2008)
However a JAMA report (2009) shows no improvement over placebo for severe depression, but then, sertraline didn't perform any better either for 2 of the primary outcomes
Increased rate of healing in 2nd & 3rd degree burns
amber, amber touch and teal (St John's Wort) adverse (side) effects
Frequency not defined
Agitation
Anxiety
Dizziness
Dry mouth
Fatigue
GI discomfort
Headache
Hypomania
Insomnia
Irritability
Menstrual irregularities
Paresthesias
Photosensitivity
Restlessness
Skin rash
Warnings
Contraindications
Hypersensitivity to Hypericum
Alzheimer's disease, bipolar disorder, psychosis, schizophrenia, tyramine-containing foods
Cautions
Avoid strong sunlight
Inducer of CYP3A4
May reduce efficacy of oral contraceptives & concentrations of CYP3A4 substrate drugs
Quality varies widely among commercial products; some contain very low quantities of hypericin
Pregnancy and lactation
Pregnancy category: unsafe
Lactation: unsafe
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of amber, amber touch and teal (St John's Wort)
Metabolism: N/A
Excretion: N/A
Mechanism of action
Active constituent: hypericin (others under investigation)
Possible dopaminergic or SSRI effects
Topical: antibacterial, increased epithelialization
