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ST. JOHN'S WORT

Hypericum perforatum L

Description

It’s a herbaceous, vivacious plant of 25-100 cm high. It’s characterized by a reddish stem which is branched from the very base, rigid with opposite branches and two protruding lines (it’s a bi-angular stem). Leaves are always positioned towards the light and are opposite, sessile, small and lanceolate, oval-shaped, entire and glabrous, with many small pellucid dots or oil glands which may be seen on holding leaf to light (that’s where its name is originated) giving the impression that the leaf is perforated. Flowers are showy, yellow and gathered in dense terminal panicles. Petals are golden yellow black-dotted along the edges and with numerous branched stamens grouped in three clusters. These yellow flowers turn red when rubbed between the fingers. The fruit is a reddish globose-ovoid capsule with three cells. Seeds are dark brown.

It blooms almost all year long (from March to December).

Part used

The flowering tops.

Indications

Internal use

  • Mild to moderate depression.
  • Nervousness, anxiety and insomnia.
  • Irritable colon syndrome.
  • Nocturnal enuresis. Sleep terror.
  • Intermittent fevers.
  • Infantile infectious diseases.
  • Bronchitis and lung infections.
  • Gastritis and gastrointestinal spasms, biliary dyskinesia, atonic dyspepsia, intestinal parasites (ascaridiasis, enterobiasis, taeniasis, toxocariasis, whipworm infection).
  • Cystitis, oliguria.
  • Gout and arthritism.

External use

  • The oil obtained by maceration, it is used in cases of insect bites, ecchymoses, burns, hemorrhoids, herpes lesions, ulcers, muscle pains, scratches, neuralgia, mammary fissures, sunburns and hives.
  • The infusion is used as an astringent in mouthwashes and gargles. The compresses are used in ecchymoses, inflammation, hurts and swelling.

  • Gels and ointments have antiseptic, anti-inflammatory and vulnerary properties; it is used in dermatosis.

Bibliography

Agencia Española del Medicamento. (2000). Real Farmacopea Española (1ª Edicion). Suplemento 2000. Ministerio de Sanidad y Consumo. Madrid. 

Agencia Española del Medicamento. Nota informativa de la AEM sobre el riesgo de interacciones medicamentosas con Hypericum perforatum (Hierba de San Juan) 2000.. 

Brantner A.; Della Logia R.; Sosa S. y Karting T. Untersuchungen zur antiphlogistischen Wirkung von Hypericum perforatum L.  Sci Pharm 1994; 62: 97-8.

Brondz I.; Greibrokk T; Groth P.A. y Aasen A.J. The relative stereochemistry of hyperforin – an antibiotic from Hypericum perforatum L. Tetrahedron Lett 1982; 23:1299-300.

Bruneton J. Pharmacognosy, phytochemistry, medicinal plants, 2ª ed.  Paris: Tecnique & Documentation, 1999.

Buendia, E. El Hiperico en el tratamiento de la depresión.  Revista de Fitoterapia 2000; 1: 37 - 42.

Denke A, Schempp H, Mann E, Schneider W, Elstner EF.. Biochemical activities of extracts from Hypericum perforatum L. 4th Communication: Influence of different cultivation methods. Arzneimittelforschung 49 (2): 120 - 125.

Editorial. Hipérico (Hypericum perforatum). The Medical Letter. 1998. 20 (1): 1 - 2.

Ernst, E. Second thoughts about safety of St. John´s wort. The Lancet. 1999; 354: 2014 - 2016.

Gordon, J.B. SSRIs and St. John´s wort: Possible toxicity?. An Fam Physician. 1998; 57 (5): 950 - 953.

Hänsgen, K.D.; Vesper, J. y Ploch, M. Multizentrische doppelblind-studie zur antidepressiven wirksamkeit des Hypericum extraktes LI 160. Nervenheilkunde 1993. 12: 285 - 289.

Hölzl J. Inhaltsstoffeund Wirkmechanismen des Johanniskrautes. Z Phytother1993;14: 255-64.

Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St John's Wort) in Major Depressive Disorder. A Randomized Controlled Trial. JAMA. 2002;287:1807-1814. 
Izzo AA. Drug interactions with St. John's Wort (Hypericum perforatum): a review of the clinical evidence. Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48.

Johne A, Brockmoller J, Bauer S, Maurer A, Langheinrich M y Roots I.. Pharmacokinetic interaction of digoxin with an herbal extract from St. John´s wort (Hypericum perforatum). Clin Pharmacol Ther 1999; 66: 338 - 345.

Johnson D, Ksciuk H, Woelk H, Sauerwein-Giese E y Frauendorf A.. Effects of Hypericum extract LI 160 compared with Maprotiline on resting EEG and evoked potential in 24 volunteers. J Geriatr Psychiatry Neurol 1994; 7 (suppl.1): S44 - S46.

Lantz, M.S.; Buchalter, E. y Giambanco, V. St. John´s wort and antidepressant drug interactions in the elderly. J Geriatr Psychiatry Neurol 1999; 12: 7 - 10.

Lehrl, S. & al. Ergebnisse von messungen der kognitiven leistungsfähigkeit bei patienten unter der therapie mit Johanniskraut-extrakt.  Nervenheilkunde 1993. 12: 281 - 284.

Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W y Melchart D.. St. ohn´s wort for depression. An overview and meta-analysis of randomized clinical trials. BMJ 1996; 313(7052):253-8.

Nebel A, Schneider BJ, Baker RK y Kroll DJ.. Potential metabolic interaction between St. John´s wort and heophylline. Ann Pharmacotherapy. 1999; 33(4): 502.

Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM y Falloon J.. Indinavir concentrations and St. John´s wort. The Lancet. 2000 Feb 12;355(9203):547-8. Erratum in: Lancet 2001 Apr 14;357(9263):1210.

Rey, J.M. y Walter, G. Hypericum perforatum (St. John´s wort) in depreession: pest or blessing?. Alternative Medicine 1998; 169: 583 - 586.

Roder C, Schaefer M y Leucht S. Meta-analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John's Word. Fortschr Neurol Psychiatr. 2004;72(6):330-43.

Rodriguez-Landa JF y Contreras CM. A review of clinical and experimental observations about antidepressant actions and side effects produced by Hypericum perforatum extracts. Phytomedicine. 2003 Nov;10(8):688-99.

Ruschitzka F, Meier PJ, Turina M, Luscher TF y Noll G. Acute heart trasplant rejection due to Saint John´s wort. The Lancet. 2000; 12;355(9203):548-9..

Schrader E. Equivalence of St. John´s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderated depression. Int Clin Psychopharmacol 2000; 15: 61 - 68.

Schinkel AH, Wagenaar E, van Deemter L, Mol CA y Borst P. Absence of the mdr 1a P-glycoprotein in mice affects tissue distribution and pharmacokinetics of dexamethasone, digoxin and cyclosporin A. J Clin Invest 1995; 96(4): 1698 - 1705.

Sommer, H. y Harrer, G. Therapie leichter/mittelschwerer Depressionen mit Hypericum. (Terapia de las depresiones ligeras/semiprofundas con Hypericum). Münch Med Wschr. 1993.  135 (22): 305 - 309.

Stevinson, C. y Ernst, E. Safety of Hypericum in patients with depression. CNS Drugs. 1999; 11 (2): 125 - 132. 

Vorbach EU, Arnoldt KH y  Hubner WD. Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10. Pharmacopsychiatry. 1997;30 Suppl 2:81-5

Vorbach, E.U.; Hübner, W.D. y Arnoldt, K.H. Effectiveness and tolerance of the Hypericum extract LI 160 in comparison with Imipramine: Randomized double-blind study with 135 outpatients. J Geriatr Psychiatry Neurol 1994; 7 (suppl. 1): S19 - S23.

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