It may also worsen symptoms of bipolar disorder and schizophrenia.

St. John’s wort can interact with other medications, including causing an increase or decrease in their effects These medications include antidepressants, phenytoin, alprazolam, barbiturates, bupropion, statin medications, dextromethorphan, oral contraceptives, triptans, cyclosporine, digoxin, oxycodone, indinavir, ketamine, irinotecan, and warfarin.^5,6

St. John’s wort can also cause photosensitivity.⁶

References

1. Linde K. St. John’s wort—an overview. Forschende Komplementärmedizin. 2009;16(3):146-155.
2. Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St. John’s wort) in major depressive disorder: a randomized controlled trial. JAMA. 2002;287(14):1807-1814.
3. Rapaport MH, Nierenberg AA, Howland R, et al. The treatment of minor depression with St. John’s wort or citalopram: failure to show benefit over placebo. J Psychiatr Res. 2011;45(7):931-941.
4. Sarris J, Fava M, Schweitzer I, et al. St. John’s wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT. Pharmacopsychiatry. 2012;45(7):275-278.
5. John’s wort and depression: in depth. National Institutes of Health website. Available at: https://www.nccih.nih.gov/health/st-johns-wort-and-depression-in-depth. Accessed May 11, 2020.
6. John’s wort. Mayo Clinic website. Available at: https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212. Accessed May 11, 2020.