St. John’s Wort and Acute Insomnia

“SJW must be as powerful a serotonergic as Prozac.”


I was so interested when I saw your web site, because from what everyone is saying, serotonin should be added to our drinking supply. Yet not enough is truly known about the brain.

Here is my story. It’s not entirely related to a drug per se, but to St. John’s Wort. I took SJW extract for three weeks in November, three droppers full a day, hoping to stave off winter depression before it hit. I then developed SEVERE insomnia that landed me in the ER twice, and then in the Psych unit. Had a sleep study to no avail. Since then I haven’t been able to sleep without ambien or halcion, despite having no prior history of insomnia. And they keep giving me more serotonergic drugs! I can’t see what it could be besides the St. John’s Wort! And I am only 22!

Zoloft was the worst drug they put me on, and gave me a dissociative panic attack for days on end. I don’t know exactly what my disorder is, but I had a deranged SPECT scan with massive overactivity. Serotonin is a double-edged sword. Watch out! All the research is definitely not in on this one. When I was younger and used to do LSD I had a lot of the same effects that SSRI’s give. They are not that dissimilar.

I would be highly interested if you ever run across anyone who had a severe disabling insomnia somehow induced by excess serotonin. I have talked to one person who had exactly the same thing happen, after a few Prozac, and it turned out they also had a carcinoid syndrome. Now, I know I don’t have this, but I don’t know how to explain any of what I have been through without mentioning the St. John’s Wort, because until that day I was 100% fine, and since then I have been unable to sleep and feeling restless. They had put me on tricyclic antidepressants and then several different SSRI’s which honestly haven’t improved things, and which I secretly discontinued. It’s not like I am depressed anyway, and in fact was in the Psych Hospital for sleep deprivation and released because they couldn’t find any evidence of a mental problem. They said maybe I was manic, but I wasn’t really hyper and had no response to Lithium or Depakote. Then they withdrew that diagnosis, only to say they didn’t know what was wrong with me.

But the thing about the SJW is this: I was on it for about three weeks of a black mood, when I honestly felt my mood lift… then I called everyone and said, “Gee this stuff really works!” Then within days the massive insomnia came. Now my mood is not so great, and I still can’t sleep. So I fail to see what induced it otherwise. All in all it’s weird. SJW must be as powerful a serotonergic as Prozac. I don’t think, if it’s so powerful, that it could really be free of side effects, even if it is natural. That is a rather grandiose claim, made by Howard (? Harold) Bloomfield, the doc who did all the SJW research. My three cents:)

Note from Ann Blake-Tracy:

Something to consider is that “Sleepless in California” had used a drug (LSD) in the past that produces high levels of serotonin. It may be that St. John’s Wort used by someone who has higher levels of serotonin already may find that they have adverse reactions to St. John’s Wort. This would also raise questions about those who have previously used an SSRI using St. John’s Wort. And to answer the question about higher levels of serotonin and insomnia, I refer you to the information in my book PROZAC: PANACEA OR PANDORA? which demonstrates that high levels of serotonin will lower the metabolism of serotonin and results in insomnia.

(Sleepless in California)

Years 2000 and Prior

This is Survivor Story number 81.
Total number of stories in current database is 96


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4/10/2002 • Effect of Hypericum perforatum (St John's Wort) in Major Depressive Disorder

4/10/2002 • Effect of Hypericum perforatum (St John’s Wort) in Major Depressive Disorder

David J. Kupfer, MD, Department of Psychiatry, University of Pittsburgh Medical School, Western Psychiatric Institute and Clinic, 3811 O’Hara St, Pittsburgh, PA 15213 (e-mail:

JAMA Vol. 287 No. 14

This study fails to support the efficacy of H perforatum in moderately severe major depression. The result may be due to low assay sensitivity of the trial, but the complete absence of trends suggestive of efficacy for H perforatum is noteworthy.

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4/9/2002 • Sugar pills offer more relief than St. John’s wort, Zoloft

4/9/2002 • Sugar pills offer more relief than St. John’s wort, Zoloft

Robert Bazell

NBC News

Even in severely depressed patients, the antidepressant drug, Zoloft, was no better than placebo.

Sugar pills offer more relief than St. John’s wort, Zoloft

Robert Bazell

NBC News

Even in severely depressed patients, the antidepressant drug, Zoloft, was no better than placebo.

Although promoted as an alternative therapy for depression, the herbal supplement St. John’s wort appears ineffective for people with moderate clinical depression, findings from a US study suggest. In the study of 340 patients diagnosed with moderate depression, St. John’s wort proved no more effective than inactive treatment with a placebo in alleviating symptoms. Active treatment with the antidepressant drug sertraline (Zoloft) worked somewhat better than placebo, according to findings published in the April 10th issue of The Journal of the American Medical Association (news – web sites).

A body of evidence suggests that St. John’s wort (Hypericum perforatum), used for more than 2,000 years to quell mood problems, does help symptoms of depression. In Germany, where many of the positive studies have been conducted, St. John’s wort is available as a prescription antidepressant.

But the quality of much of this research has been criticized—including the lack of studies using a placebo and a selective serotonin reuptake inhibitor (SSRI) like sertraline, according to the authors of the new study. SSRIs are a newer class of drugs commonly used to treat depression.

To address these concerns about earlier studies, researchers led by Dr. Jonathan R. T. Davidson of Duke University in Durham, North Carolina, randomly assigned patients to take St. John’s wort, sertraline or placebo for up to 26 weeks.

At the study’s end, the researchers found that neither the herb nor the drug was better than placebo in improving patients’ scores on a standard scale of depressive symptoms. Overall, nearly one third of placebo patients showed a full response to treatment, compared with roughly 24% in both the St. John’s wort and sertraline groups.

Patients on sertraline did, however, do better than placebo patients on a secondary test used to gauge a person’s daily functioning and levels of distress. The sertraline group also had a higher percentage of so-called “partial responders” to treatment than either the placebo or St. John’s wort groups.

Still, the findings do not indicate whether the herb can help people with mild depressive symptoms—a question additional research will have to address, Davidson told Reuters Health. St. John’s wort is marketed for the treatment of mild to moderate depression, but Davidson noted that it’s likely people with a range of depressive disorders try the herb.

“If someone is suffering from depression for weeks, they’re much better off going to a healthcare professional…than trying to self-treat,” he said.

And because St. John’s wort can interact with a range of drugs, including some used to treat cancer and HIV (news – web sites), people who do use the herb “should always tell their doctor they’re using it,” Davidson added.

As for the findings on sertraline, the researcher said that dosing “had a lot to do with” the lack of full response among patients on the drug. The study design permitted sertraline to be given only up to half of its highest recommended dose, and fewer patients on the drug had their doses “maximized,” compared with those on St. John’s wort or placebo.

Dosing “almost certainly contributed” to sertraline’s less-than-stellar performance in the study, according to an accompanying editorial by Drs. David J. Kupfer and Ellen Frank of the University of Pittsburgh Medical School in Pennsylvania.

They also stress that this study—along with a second one in the same journal issue documenting the rise of the “placebo effect” in recent research on depression drugs—highlight the importance of using a placebo and an active comparison drug in studies of unproven antidepressant agents.

The New York-based drug company Pfizer Inc. provided the sertraline for the study, and Lichtwer Pharma of Berlin, Germany, supplied the St. John’s wort product. Davidson holds stock in Pfizer, and has received speaker fees from both Pfizer and Lichtwer. Co-authors on the study have received funding from a number of pharmaceutical companies.

The study itself was funded by the US National Institutes of Health.

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