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.

There are numerous clinical trials demonstrating St. John’s wort’s effectiveness in treating mild to moderate depression.

The only use of St. John’s wort is to treat depression.

St. John’s wort is safe for use by persons who work outdoors.

St. John’s wort has no known interactions with any medications.