Over-the-counter herbal medicines, such as St John’s Wort, a herbal antidepressant with a variety of actions including inhibition of serotonin reuptake, are widely perceived as being safe. Yet research into toxicity associated with St John’s Wort shows that the profile of adverse drug reactions (ADRs) is similar to that of conventional antidepressant drug fluoxetine, a selective serotonin reuptake inhibitor.
Researchers analysed spontaneously reported ADRs to St John’s Wort (Hypericum perforatum; n=84) and to fluoxetine (n=447) in Australia between 2000 and 2013. For both drugs, the majority of ADRs affected women aged 26–50 years, were mild to moderate in severity, and involved the central nervous system.
results highlight an “urgent need for a comprehensive survey of overall herbal medicine usage,” the authors conclu
de in Clinical and Experimental Pharmacology and Physiology (online, 1 July 2015).
 Hoban CL, Byard RW & Musgrave IF. A comparison of patterns of spontaneous adverse drug reaction reporting with St. John’s Wort and fluoxetine during the period 2000–2013. Clin Exp Pharmacol Physiol 2015;42:747–751. doi:10.1111/1440-1681.12424.