What are other supplements similar to St. John's Wort (Hypericum perforatum)?

From the Guidelines

Supplements similar to St. John's Wort include SAM-e, 5-HTP, saffron extract, rhodiola rosea, and omega-3 fatty acids, which are commonly used for mood support and mild to moderate depression. These alternatives work through different mechanisms, such as supporting neurotransmitter production, increasing serotonin, having antidepressant properties, acting as an adaptogen to reduce stress, and reducing inflammation that may contribute to depression. Some key points to consider when using these supplements include:

• SAM-e typically requires 400-1600 mg daily in divided doses 1
• 5-HTP is often taken at 50-300 mg daily
• Saffron extract is effective at 30 mg daily
• Rhodiola rosea at 340-680 mg daily
• Omega-3 supplements containing EPA and DHA are generally taken at 1-2 grams daily It's essential to note that these supplements should not replace prescribed medications, and you should consult with a healthcare provider before starting any supplement, especially if you're taking other medications, as interactions can occur similar to St. John's Wort's known interactions with many drugs 1. Additionally, the evidence suggests that St. John's Wort may be as effective as second-generation antidepressants for treating major depressive disorder, but it is not currently regulated by the U.S. Food and Drug Administration, and there is no current standard in place about the contents and potency of the medication 1. Therefore, when considering supplements similar to St. John's Wort, it's crucial to prioritize the potential benefits and risks, as well as the quality of the supplement, to ensure the best possible outcome for morbidity, mortality, and quality of life.

From the Research

Supplements Similar to St. John's Wort

Other supplements that are similar to St. John's Wort (Hypericum perforatum) in terms of their potential interactions with prescription medications or their use for similar health purposes include:

• Goldenseal: known to cause clinically important drug interactions and should be avoided by most patients receiving any pharmacologic therapy 2
• Curcumin: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Echinacea: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Garlic: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Asian ginseng: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Green tea extract: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Kava kava: predicted to cause interactions based only on in vitro studies, but may be safe with other medications 2
• Black cohosh: has a low likelihood of drug interactions and can safely be taken with most medications 2
• Cranberry: has a low likelihood of drug interactions and can safely be taken with most medications 2
• Ginkgo: has a low likelihood of drug interactions and can safely be taken with most medications 2
• Milk thistle: has a low likelihood of drug interactions and can safely be taken with most medications 2
• American ginseng: has a low likelihood of drug interactions and can safely be taken with most medications 2
• Saw palmetto: has a low likelihood of drug interactions and can safely be taken with most medications 2, 3
• Valerian: has a low likelihood of drug interactions and can safely be taken with most medications 2
• S-Adenosylmethionine (SAMe): has enough of an antidepressant effect to warrant further research 4

Supplements for Specific Health Purposes

For depression, other supplements that may be used include:

• S-Adenosylmethionine (SAMe) 4 For diabetes, other supplements that may be used include:
• Chromium 4
• Alpha lipoic acid: used in the treatment of diabetic neuropathy 4 For obesity, other supplements that may be used include:
• Ma huang/guarana combinations: may have potentially serious side effects but may also offer some benefit 4
• Hydroxycitric acid and garcinia: proved no more effective than placebo 4