St. John's Wort for Anxiety
Verdict: Counter-Evidence
Across 3 PubMed studies, the evidence for St. John's Wort in Anxiety grades Tier D — counter-evidence. High-quality evidence indicates it is not effective (or is harmful) for this use.
D 🔴 D Counter-Evidence Counter-Evidence
Why this grade7-layer evidence engine
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Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.40
D
C
B
A
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← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
D · Counter-Evidence
Confidence
74%
Broadly consistent
Evidence level
E6
Multiple smaller RCTs (n<500)
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.397
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — D 級條件未達 (需 E1-E3 negative；實際 E6)
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (3)L2 · primary research & systematic reviews
St John's wort versus placebo in obsessive-compulsive disorder: results from a double-blind study
Finding: In 60 OCD patients randomized to St John's wort or placebo over 12 weeks, mean Y-BOCS change with St John's wort (3.43 points) was not significantly different from placebo (3.60 points), and no Y-BOCS subscale differed; the authors concluded St John's wort is not an efficacious treatment for OCD.
View on PubMed St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study
Finding: In 40 outpatients with primary social phobia randomized to St John's wort or placebo over 12 weeks, mean LSAS change did not differ between St John's wort (11.4) and placebo (13.2), p=0.27, effect size -0.09; this pilot RCT failed to provide evidence of efficacy for Hypericum in social anxiety disorder.
View on PubMed Treating depression comorbid with anxiety: results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses
Finding: In an open, practice-oriented study of patients with depression comorbid with anxiety, both St John's wort monotherapy and the St John's wort plus valerian combination improved anxiety and depression symptoms; anxiety symptoms improved more quickly with the combination than with St John's wort alone, and treatment was well tolerated. Open-label design without placebo limits causal inference about St John's wort's anxiolytic effect.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Cautious
St. John's Wort appears to be an inducer of an important metabolic pathway, cytochrome P450. As many prescription drugs used to treat conditions such as heart disease, depression, seizures, certain cancers or to prevent conditions such as transplant rejection or pregnancy (oral contraceptives) are metabolized via this pathway, health care providers should alert patients about these potential dr… source↗
L4b EU EFSA
Cautious
L4c UK NHS
Against
St John's wort is a herbal treatment that some people take for depression. ... There's some evidence that it may help less severe depression, but it's not recommended by doctors. This is because the amount of active ingredients varies among individual brands and batches, so you can never be sure what sort of effect it'll have on you. Taking St John's wort with other medicines, such as anticonvu… source↗
L4d TW TFDA / 衛福部
Cautious
根據台灣衛生福利部的規定，聖約翰草不能當作一般食品原料使用，因此在台灣無法購買到合法含有聖約翰草的食品。 source↗
L4e WHO
Supportive
Herba Hyperici. WHO Monographs on Selected Medicinal Plants, Volume 2 (Geneva: World Health Organization, 2002), pp. 149-171. The crude drug herba hyperici consists of the dried flowering aerial parts of Hypericum perforatum L. Uses supported by clinical data include the symptomatic treatment of mild to moderate depressive disorders. Verbatim section text of the WHO monograph could not be extra… source↗
L5a NIH Office of Dietary Supplements
Cautious
L5b Mayo Clinic
Cautious
St. John's wort might help treat somatic symptom disorder, a condition that causes a heightened focus on physical symptoms such as pain or fatigue... Taking St. John's wort with alprazolam (Xanax), a medicine used to ease anxiety symptoms, might lessen the medicine's effect. source↗
L5c Cleveland Clinic
Cautious