St. John's Wort
St. John’s Wort is an herbal supplement derived from the Hypericum perforatum plant and is commonly used for mild to moderate depression. It is believed to influence serotonin, dopamine, and norepinephrine pathways in the brain. The supplement is often used as a natural alternative to prescription antidepressants. However, it can interact with many medications by affecting drug metabolism, which can lead to reduced effectiveness or increased risks.
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This page summarizes anecdotal reports and community observations, not medical evidence. Reports may be incomplete, biased or inaccurate and are not medical advice or recommendations. “Risk” here refers to how frequently severe or prolonged symptom worsening is reported, not to proven causation or population-wide probability. Individual responses vary widely, and absence of issues in some users does not rule out significant reactions in others.
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Within PFS/PSSD/PAS communities, St. John's Wort is discussed in relation to its potential interactions with serotonergic and monoamine signaling pathways. Its best-studied active constituents—especially hyperforin—are associated with inhibition of monoamine reuptake (serotonin, norepinephrine, dopamine) and broader neurochemical effects, which is why it can noticeably affect mood, anxiety, sleep, and libido in some people. St. John's Wort can meaningfully shift serotonergic and monoaminergic signaling in an SSRI-like direction. These mechanisms may interact with pathways involving serotonin, norepinephrine, or dopamine signaling that are often discussed in relation to PFS / PSSD / PAS. (ncbi) (bpspubs) (stuffthatworks (clevelandclinic)
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Mixed Reports of Severe and Sometimes Lasting Worsening (for PFS/PSSD/PAS):
Among individuals who already have PFS/PSSD/PAS, St. John’s Wort is commonly mentioned in community reports as preceding symptom worsening, sometimes described as prolonged. Concerns typically center on SSRI-like serotonergic effects (mood/anhedonia shifts, emotional blunting, sleep disruption, sexual symptoms) and the unpredictability introduced by product variability and drug–drug interactions. There are rare reports of St. John’s Wort improving PFS/PSSD/PAS. Because outcomes appear highly variable and crashes are reported, many in the community view the substance as carrying a moderate risk.
For individuals without these conditions, St. John’s Wort is widely used, but significant side effects and interactions can still occur.
Evidence basis: Established pharmacology and interaction literature; mainstream medical safety guidance; anecdotal reports (online forums, self-reports); no controlled studies examining PFS/PSSD/PAS-specific outcomes.
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Crash / Baseline Drop (Reported)
Crash / Baseline Drop (Reported)
“Cure/Recovery” Claim
Public comments reflect individual experiences and opinions. They are not medical advice and may not be accurate or representative.