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St. John’s wort, or Hypericum perforatum, is a perennial, herbaceous shrub . In recent years, significant clinical attention has been dedicated to St. Johns wort’s capabilities as a mood stabilizer .
Benefits and Effects
Adjuvant Treatment for Mild to Moderate Depression
One study showed St. John’s wort alleviated depressive symptoms more effectively than both placebo and fluoxetine. Patients were evaluated based on the 17-item Hamilton Rating Scale for Depression .
Conversely, a clinical trial conducted over a period of twelve weeks found St. John’s wort did not ameliorate depressive symptoms in seventy-three patients in comparison to placebo .
St. John’s wort extract, among 124 participants, was effective in treating moderate depression. Parameters were established based on the Hamilton Rating Scale for Depression .
Overall, St. John’s wort’s efficacy as an antidepressant shows slightly mixed results .
Alleviation of Menopausal Symptoms
Therapeutic efficacy of St. John’s wort in 107 menopausal women observed substantial improvements in psychological health, climacteric resilience, and sexual well-being among patients .
Topical Treatment for Eczema
Researchers observed that, over four weeks, the St. John’s wort cream significantly alleviated the severity of eczematous lesions in comparison to placebo 
A 2015 study found that St. John’s wort had the capacity to enhance fibroblast proliferation and collagen synthesis, thus escalating wound closure rate .
How Does St. John’s Wort Work?
St. John’s wort’s bioactive compounds include the following: napthodianthrones (hypericin, pseudohypericin, protohypericin, and cyclopseudohypericin), flavonoids (quercetin, luteolin, and rutin), and hyperforin, as well as a variety of pharmacologically potent amino acids .
St. John’s wort inhibits the synaptosomal uptake of serotonin, dopamine, and noradrenaline/norepinephrine. St. John’s wort has also demonstrated affinity for adenosine, GABA, and glutamate receptors, all of which regulate the release of stress hormones as well as neuronal excitability .
Like Centella asiatica, St. John’s wort stimulates fibroblast collagen production, which aids cells in closing damaged wound areas and lesions .
The standard St. John’s wort dosage for depression in adults is 300 mg thrice daily .
A European Journal of Clinical Pharmacology review found that St. John’s wort did not have a significant adverse effects profile in comparison to placebo .
Side effects alongside supplementation have been observed and include increased urinary frequency, gastrointestinal symptoms, lightheadedness, drowsiness, or confusion, and photosensitivity in rare cases .
St. John’s wort and birth control are contraindicated, as the plant has been demonstrated to reduce the efficacy of oral contraception.
While St. John’s wort and alcohol are not contraindicated specifically, the supplement may enhance the soporific effects of ethanol . The relationship between the herb and alcohol are still being elucidated.
Pregnant or breastfeeding individuals should avoid taking St. John’s wort. It has also been revealed in clinical research that St. John’s wort can be excreted into breast milk at low levels .