St. John's wort is a plant with yellow flowers that today is used as a herbal supplement for the treatment of mild to moderate depression, anxiety and sleep disorders. Its first medicinal use is thought to have been in ancient Greece. The name St. John's wort apparently refers to John the Baptist, as the plant blooms around the time of the feast of the Saint in late June.

The Latin name for the plant is Hypericum perforatum while common names include St. John's wort, hypericum, Klamath weed and goat weed. Hypericum is thought to be the most active compound found in the plant and most St. John's wort supplements are standardised to 0.3% hypericum.

The US National Institutes of Health (NIH) Medline Plus website reports that St. John's wort is at least as effective as tricyclic antidepressants (e.g. amitriptyline) in the treatment of mild to moderate depression and maybe even more effective. Compared to the newer slective serotonin reuptake inhibitor (SSRI) antidepressants such as fluoxetine (Prozac) and sertraline (Zoloft®) the NIH say there is less evidence but studies so far suggest St. John's wort may be equally as effective with fewer side-effects.

In conclusion the NIH says "Overall, the scientific evidence supports the effectiveness of St. John's wort in mild-to-moderate major depression. The evidence in severe major depression remains unclear."

The exact way(s) by which St. John's wort exerts its antidepressant effects are yet to be determined but studies have suggested it works by a variety of mechanisms. It is thought to be a mild monoamine oxidase inhibitor (MAOI) (which is how older MAOI antidepressant drugs like Parnate worked), it blocks reuptake of serotonin, dopamine and noradrenaline like newer drugs and it also reduces the activity of the hypothalamic-pituitary-adrenal (HPA) axis, the stress response system of the body. To learn more see this research paper. 

As with any medication, herbal remedy or nutritional supplement St. John's wort has side-effects. Some of these include increased sensitivity to sunlight, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction. The herb also interferes with the cytochrome P450 enzymes in the liver which metabolise certain drugs and can thus interefere with the action of certain medications. You should therefore talk to your doctor if you are using St. John's wort and are on other medications (See Medline Plus for more details).

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Valerian, or Valeriana officinalis, to give it its botanical name, is a plant native to Europe and Asia. It grows up to four feet high and has trumpet-shaped flowers. It is the roots of the plant that are used for their medicinal properties; these are mainly useful for nervous disorders.

Valerian has a long history of use as a herbal medicine, at least the time of ancient Greece and Rome. Its properties were described by Hippocrates and Galen later prescribed it as a remedy for insomnia, a condition it is still popularly used for today.

As with many medicinal herbs, valerian does not contain just a single active compound, but a large variety which may act together to produce the pharmacological effects. Some of the pharmacologically active constituents isolated by scientists include the alkaloids catinine, valerianine and valerine, gamma-aminobutyric acid (GABA) and the flavones hesperidin and linarin.

What Conditions is Valerian Used For?

Valerian appears to have mild sedative and anxiolytic (anxiety-reducing/tranquilizing) properties so is primarily used in the treatment of nervous disorders including anxiety, insomnia, stress, migraine and tension headaches.

Is Valerian Proven to Work in These Conditions?

Valerian is generally used based on its traditional use which provide anecdotal evidence that it helps the conditions named above and a number of others - but what does medical research say?

Unfortunately the number and quality of medical research into valerian is currently limited. The best evidence so far is for its use in insomnia where some studies have found it to be even more effective than benzodizepine drugs (although others have found contradictory results). Extracts of valerian have been tested in anxiety in only a few studies but some have shown promising results. The evidence so far for using valerian must however be considered inconclusive.

How does it Work?

Most research points to valerian acting on the GABA neurotransmitter system in the brain and central nervous system. GABA is the major inhibitory neurotransmitter meaning it reduces nerve activty. The benzodiazepine tranquilizing drugs such as diazepam (Valium) bind to GABA receptors to ehance its inhibitory effects and it seems that valerian may work in a similar way, although not as potently. It could also be that valerian increases the production of GABA or slows the rate at which it is broken down.

Another possible explanation for valerian's medicinal properties could be its interaction with adenosine receptors which may produce a sedative effect.



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