Implications of self-administered St. John's wort for depression symptom management

To provide nurse practitioners (NPs) with a greater understanding of the complex issues surrounding St. John's wort as a self-treatment for depression; to review laws regulating the production and sale of herbal products in the United States (U.S.); and to review clinical and practice implications for the self-administration of St. John's wort and herbal treatments.

Federal regulations pertaining to herbal products, current research literature, and anecdotal and consumer reports.

Current research findings suggest that St. John's wort may be an effective treatment for mild depression; however, evidence of significant adverse drug interactions with St. John's wort should not be overlooked.

Clinical assessment of the mildly depressed patient wishing to self-administer St. John's wort requires basic knowledge of this herbal supplement including regulation and risk information. An open NP-patient relationship helps to ensure patient disclosure of self-administered St. John's wort.