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Page: Pharmacology
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The exact mechanism by which St. John's wort — and even conventional antidepressants — function is unclear and subject to conjecture.
The St. John's wort mechanism is believed to involve inhibition of serotonin (5-HT) reuptake, much like the conventional selective serotonin reuptake inhibitor (SSRI) antidepressants. It may thus be useful to review that information before using, particularly the complications. The link to the Prozac Product/Prescribing Information is provided below.
The major active constituents in St John's wort are thought to be hyperforin and hypericin, although other biologically active constituents present, for example, flavonoids and tannins, may also be involved.
Hyperforin has also been found to have excellent antibacterial properties; in ultrapurified form a concentration of 0.1mg/ml kills methicillin-resistant forms of Staphylococcus aureus (MRSA) (quotation from wissenschaft-online, in German).
Some believe that hyperforin is the major constituent responsible for antidepressant activity, and it has been shown to inhibit the uptake of 5-HT, dopamine, noradrenaline, GABA and glutamate. Discrepancies in the dose-response relationship imply that constituents other than hyperforin are likely to also be involved. Also, a hyperforin free extract of St John's wort (Ze 117 - Remotiv) has been shown to have significant antidepressive effects. Therefore current thinking is that the whole extract should be considered the "active ingredient" and that one or two constituents cannot explain the activity of the product.
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