Case

A teenaged patient with a past medical history of depression
comes to you because she wants to stop taking her Prozac and try St. John’s wort instead. In addition to her depression, she also has a history of IV drug use and is HIV positive. Her HIV medications, which include AZT and Indinavir, a protease inhibitor, have helped her remain asymptomatic. She also tells you that she has gotten a new job as a landscaper and is excited about working outside.

Answer A is correct.
There are over 20 randomized clinical trials demonstrating that St. John’s wort is helpful in treating mild to moderate depression in adults.

St. John's wort is also used to treat anxiety, stomach upset, insomnia, fluid retention, nerve and muscle pain, skin inflammation, skin wounds, burns and viral infections.
St. John's wort may cause marked photosensitivity.
St. John's Wort can enhance clearance of other medications such as digoxin, cyclosporine and protease inhibitors (Indinavir), leading to subtherapeutic levels of these medications.

FOR MORE INFORMATION ABOUT ST. JOHN'S WORT
Our St. John's wort page has links to information on other websites.

Click here.

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Last Updated: August 24, 2001
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