Hypericum perforatum.  Saint John's wort   Family: Hypericaceae  
Known as a weed, which farmers eradicate in Australia. Contains a toxin that causes dermatitis and photo-sensitivity in livestock.
Hypericum originated from the Greek name for the plant, hyperikon. Literally translated, the name is an amalgamation of the root words "hyper" (meaning over) and "eikon" (meaning image or apparition), referring to the plant’s supposed ability to ward off evil spirits

PART USED: Aerial parts. Gathered during the flowering period or shortly before. It grows up to 90 cm tall bearing bright yellow five petalled flowers.
FLAVOR: Bitter and astringent ODOR: Aromatic
ACTIONS
GROUP: Herbs for trauma and recovery- Vulnerarys
1. Sedative nervine.[1,2,5] Anxiolytic.[5]
2. Analgesic.
3. Antiseptic.
4. Astringent.[1,2,5]
5. Antiinflammatory.[5]
Topically- Analgesic, Antiseptic.[1] Vulnerary.[5]
INDICATIONS
1. Neuralgia.[1,2] Sciatica,[1,2] shooting pains from the site of old or current injuries spinal pains or inflammation. Menopausal neurosis.[1,2]  Injuries involving nerve damage. Excitability.[1]
2. Mild to moderate depressive disorders.[13,14,15,16,17,18]
2. Dyspepsia. Intestinal catarrh.
3. Wounds, especially if dirty or septic and especially in areas of nerve concentration e.g. fingers, toes. Boils, cellulitis, lymphangitis. Skin rashes of nervous origin- local use also.
4. Hemorrhoids with pain bleeding and tenderness-  local use also
5. Fibrositis.[1,2]
6. Menopausal problems.[5]
7. Lower respiratory disorders. Coughs and colds.[5]
8. Enuresis.
9. Rheumatism.[5]
Topically- Wounds.[1]
SPECIFIC INDICATIONS: Menopausal neurosis.[1]
CONTRAINDICATIONS: Depressive states.[1]- Clinical trials indicate Hypericum is effective for low grade depression, though its use in severe depression is more contraversial.
COMBINATIONS
- Lotion for external application for contusions and as an application to hemorrhoids, with Hamamelis water.
- Parodontitis, with Calendula.
- Contusions, with Calendula as a lotion.
PREPARATIONS: 3X /day
Dried herb  2-4 g,[1,2] or by infusion[1] 1:20.[2]
Fluid extract  1:1 in 25% alcohol  2-4 ml.[1,2,5] 1:1 60%.[1]
Tincture  1:10 in 45% alcohol  2-4 ml.[1,2]
External applications - see infused oil
Local: Compress, ointment.[2]
       
PART USED: Infused oil of inflorescence
ACTIONS
1. Vulnerary.[5] Anti-inflammatory.[5] Analgesic.[1,5] Antimicrobial.[5] Antiseptic.[1,5] Antiviral and astringent.[5] Antibacterial activity.[10,11,12]
INDICATIONS
1. Burns, bruises, swelling and shingles.[6,7,8,9]
PREPARATIONS: Infused inflorescence.
When gathering the inflorescence, pull the flower inflorescence upwards and the flowers break off the stem. Collect in plastic bags to prevent evaporation of constituents. Add to large glass jar, and pour virgin olive oil, to cover the flowers. Leave in a sunny place- perhaps on a window shelf, for 1 month. Pour into a cooking sieve and the result is infused St John's wort oil. The oil should be bright red, as were your fingers when pulling the flowers.[4] Best used within 12 months.
       
ORIGIN: European, including British.
DESCRIPTION: Leaves opposite, sessile, oval to linear, wtih translucent oil glands on the surface and black dots on the lower surface in same cases. Flowers bright yellow, with numerous stamens, five petals, often black dotted along the margins. There are two raised lines along the stem.
References
Inner Path can not take any responsibility for any adverse effects from the use of plants. Always seek advice from a professional before using a plant medicinally.
Constituents
Safety and herb-drug interactions.
Research
Reported to cause photosensitisation in cattle and sheep.[1]
The hypericins have an anxiolytic effect by monoamineoxidase inibition.[2] In a clinical trial of the sandardized extract, significant improvement in symptoms of anxiety was noted in women after four to six weeks treatment.[3]
References
[1] Kreitmair (1950), Pharmazie 5, 556. Pace & Mackinney (1941), J. Amer. chem. Soc. 63, 2570.
[2] Suzuki, O. et al. (1984) Planta Med. 3, 272
[3] Muldner, H. and Zoller, M. (1984) Marneim. Forsch. 34 II (8), 918

Hypericum perfolium Analysis JPBA pdf

St. John's Wort (Hypericum perforatum): clinical effects on depression and other conditions.
Miller AL.
Abstract
St. John's Wort (Hypericum perforatum), a perennial flowering plant, has been used medicinally for thousands of years, and has most recently been identified as an effective treatment for mild to moderate depression. Clinical studies on the use of this plant for depression have utilized liquid tinctures and standardized solid extracts (0.3% hypericin--300 mg three times a day). Severe depression may also respond to this botanical, although it appears a larger dose is needed (600 mg solid extract three times a day). Hypericum has been favorably compared to numerous antidepressant drugs, the studies having revealed equivalent results and a much more favorable incidence of side effects. Studies have also demonstrated its efficacy in treating seasonal affective disorder. In vitro investigations of Hypericum show antiviral activity, although there is evidence these promising results might not occur in vivo. Traditional actions and uses include enhancement of wound healing, as well as anti-inflammatory and analgesic activity.
PMID: 9600023  Altern Med Rev. 1998 Feb;3(1):18-26. ncbi.nlm.nih.gov

Topical application of St. John's wort (Hypericum perforatum).
Wölfle U, Seelinger G, Schempp CM.
Abstract
St. John's wort (Hypericum perforatum) has been intensively investigated for its antidepressive activity, but dermatological applications also have a long tradition. Topical St. John's wort preparations such as oils or tinctures are used for the treatment of minor wounds and burns, sunburns, abrasions, bruises, contusions, ulcers, myalgia, and many others. Pharmacological research supports the use in these fields. Of the constituents, naphthodianthrones (e.g., hypericin) and phloroglucinols (e.g., hyperforin) have interesting pharmacological profiles, including antioxidant, anti-inflammatory, anticancer, and antimicrobial activities. In addition, hyperforin stimulates growth and differentiation of keratinocytes, and hypericin is a photosensitizer which can be used for selective treatment of nonmelanoma skin cancer. However, clinical research in this field is still scarce. Recently, sporadic trials have been conducted in wound healing, atopic dermatitis, psoriasis, and herpes simplex infections, partly with purified single constituents and modern dermatological formulations. St. John's wort also has a potential for use in medical skin care. Composition and stability of pharmaceutical formulations vary greatly depending on origin of the plant material, production method, lipophilicity of solvents, and storage conditions, and this must be regarded with respect to practical as well as scientific purposes.
Georg Thieme Verlag KG Stuttgart · New York.
PMID: 24214835 DOI: 10.1055/s-0033-1351019 Planta Med. 2014 Feb;80(2-3):109-20. doi: 10.1055/s-0033-1351019. Epub 2013 Nov 8. ncbi.nlm.nih.gov

St John's wort (Hypericum perforatum): drug interactions and clinical outcomes
L Henderson, Q Y Yue, C Bergquist, B Gerden, and P Arlett
Abstract
Aims
The aim of this work is to identify the medicines which interact with the herbal remedy St John's wort (SJW), and the mechanisms responsible.
Methods
A systematic review of all the available evidence, including worldwide published literature and spontaneous case reports provided by healthcare professionals and regulatory authorities within Europe has been undertaken.
Results
A number of clinically significant interactions have been identified with prescribed medicines including warfarin, phenprocoumon, cyclosporin, HIV protease inhibitors, theophylline, digoxin and oral contraceptives resulting in a decrease in concentration or effect of the medicines. These interactions are probably due to the induction of cytochrome P450 isoenzymes CYP3A4, CYP2C9, CYP1A2 and the transport protein P-glycoprotein by constituent(s) in SJW. The degree of induction is unpredictable due to factors such as the variable quality and quantity of constituent(s) in SJW preparations. In addition, possible pharmacodynamic interactions with selective serotonin re-uptake inhibitors and serotonin (5-HT1d) receptor-agonists such as triptans used to treat migraine were identified. These interactions are associated with an increased risk of adverse reactions.
Conclusions
In Sweden and the UK the potential risks to patients were judged to be significant and therefore information about the interactions was provided to health care professionals and patients. The product information of the licensed medicines involved has been amended to reflect these newly identified interactions and SJW preparations have been voluntarily labelled with appropriate warnings.
Br J Clin Pharmacol. 2002 Oct; 54(4): 349–356.
doi: 10.1046/j.1365-2125.2002.01683.x
PMCID: PMC1874438
PMID: 12392581 ncbi.nlm.nih.gov

Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients.
Wurglics M, Schubert-Zsilavecz M.
Abstract
Hypericum perforatum (St John's Wort [SJW]) counts among the most favourite herbal drugs, and is the only herbal alternative to classic synthetic antidepressants in the therapy of mild to moderate depression. Several clinical studies have been conducted to verify the effectiveness of ethanolic or methanolic extracts of SJW. Alcoholic SJW extracts are a mixture of substances with widely varying physical and chemical properties and activities. Hyperforin, a phloroglucinol derivative, is the main source of pharmacological effects caused by the consumption of alcoholic extracts of SJW in the therapy of depression. However, several studies indicate that flavone derivatives, e.g. rutin, and also the naphthodianthrones hypericin and pseudohypericin, take part in the antidepressant efficacy. In contrast to the amount of documentation concerning clinical efficacy, oral bioavailability and pharmacokinetic data about the active components are rather scarce. The hyperforin plasma concentration in humans was investigated in a small number of studies. The results of these studies indicate a relevant plasma concentration, comparable with that used in in vitro tests. Furthermore, hyperforin is the only ingredient of H. perforatum that could be determined in the brain of rodents after oral administration of alcoholic extracts. The plasma concentrations of the hypericins were, compared with hyperforin, only one-tenth and, until now, the hypericins could not be found in the brain after oral administration of alcoholic H. perforatum extracts or pure hypericin. Until now, the pharmacokinetic profile of the flavonoids in humans after oral administration of an alcoholic H. perforatum extract has been investigated in only one study. More data are available for rutin and the aglycone quercetin after administration of pure substances or other flavonoid sources.
PMID: 16640452 DOI: 10.2165/00003088-200645050-00002
Clin Pharmacokinet. 2006;45(5):449-68. ncbi.nlm.nih.gov

An in vivo study of Hypericum perforatum in a niosomal topical drug delivery system
Mohamed Ali, Amira Abdel Motaal, Mohammed A. Ahmed ORCID Icon, Abdulrhman Alsayari & Omaima N. El-Gazayerly
Abstract
The active compounds present in Hypericum perforatum L. (Hypericaceae) include hyperforin, hypericins and flavonoids, which are assumed to be responsible for the activity of the extract in the treatment of wounds and scars. The present study aimed to incorporate H. perforatum extract standardized to a known content of phloroglucinols, naphthodianthrones and polyphenolic compounds into an effective transdermal drug delivery system capable of entrapping both lipophilic and hydrophilic constituents in the form of niosomal gels for wound treatment. An 80% ethanol extract (HE) was prepared on a pilot scale using DIG-MAZ. An HPLC-DAD holistic profile was established for HE and was standardized to contain 3.4?±?4 rutin, 1.1?±?3 chlorogenic acid, 0.5?±?2 quercitrin, 2.8?±?2 hyperforin, and 0.51?±?3% w/w total hypericins. Niosomes were prepared using the modified reverse phase evaporation technique (REV). The wound healing effect of the gel was tested on 16 adult mongrel dogs. A significant decrease in the inflammatory cell count (18.4?±?5.3) was recorded in the niosomal gel 1.5% NaCMC-treated group at the 7th day post wounding. It induced a marked regression in the inflammatory phase and enhanced the early beginning of the proliferative phase of wound healing. After 21?days, it showed complete re-epithelization, formation of new matrix fibers and significant reduction in the wound size, compared to the control and the Panthenol® 2% cream treated groups. This is the first study of H. perforatum in a niosomal topical drug delivery system.
31 Jan 2018
Download citation https://doi.org/10.1080/10717544.2018.1431977 tandfonline.com

Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis
Qin Xiang Ng, Nandini Venkatanarayanan, Collin Yih Xian Ho
Abstract
Introduction: St John's wort is a popular herbal remedy recommended by Traditional Chinese Medicine (TCM) practitioners and licensed and widely prescribed for depression in many European countries. However, conflicting data regarding its benefits and risks exist, and the last large meta-analysis on St John's wort use for depression was done in 2008, with no updated meta-analysis available.
Methods: Using the keywords [St John's Wort OR Hypericum perforatum OR hypericin OR hyperforin OR johanniskraut OR] AND [depression OR antidepressant OR SSRI], a preliminary search (without language restriction) on the PubMed, Ovid, Clinical Trials Register of the Cochrane Collaboration Depression, Anxiety and Neurosis Group, Cochrane Field for Complementary Medicine, China National Knowledge Infrastructure and WanFang database yielded 5428 papers between 1-Jan-1960 and 1-May-2016.
Results: 27 clinical trials with a total of 3808 patients were reviewed, comparing the use of St John's wort and SSRI. In patients with depression, St John's wort demonstrated comparable response (pooled RR 0.983, 95% CI 0.924-1.042, p<0.001) and remission (pooled RR 1.013, 95% CI 0.892-1.134, p<0.001) rate, and significantly lower discontinuation/dropout (pooled OR 0.587, 95% CI 0.478-0.697, p<0.001) rate compared to standard SSRIs. The pooled SMD from baseline HAM-D scores (pooled SMD -0.068, 95% CI -0.127 to 0.021, p<0.001) also support its significant clinical efficacy in ameliorating depressive symptoms.
Limitations: Evidence on the long-term efficacy and safety of St. John's wort is limited as the duration of all available studies ranged from 4 to 12 weeks. It is also unclear if St John's wort would be beneficial for patients with severe depression, high suicidality or suicide risk.
Conclusion: For patients with mild-to-moderate depression, St John's wort has comparable efficacy and safety when compared to SSRIs. Follow-up studies carried out over a longer duration should be planned to ascertain its benefits.
J Affect Disord 2017 Mar 1;210:211-221. doi: 10.1016/j.jad.2016.12.048. Epub 2017 Jan 3. PMID: 28064110 pubmed.ncbi.nlm.nih.gov

Comprehensive phytochemical characterization of St. John's wort ( Hypericum perforatum L.) oil macerates obtained by different extraction protocols via analytical tools applicable in routine control
M Heinrich, R Daniels, F C Stintzing, D R Kammerer
Abstract
The aim of the present study was to investigate the impact of crucial process parameters, i.e. of light and temperature conditions, during the preparation of St. John's wort (SJW, Hypericum perforatum L.) Arachis oil macerates. Extracts were prepared according to a standardized protocol over a period of 28 days. For this purpose, flowering tops of H. perforatum were macerated with Arachis oil (drug extract ratio, DERnative 1:4) under different light and temperature conditions. Spectrophotometric measurements were carried out to quantitate naphthodianthrones and to characterize extract color in the CIE L*C*h° system. Moreover, individual plant secondary metabolites were screened by UHPLC-DAD-MSn measurements following liquid-liquid extraction of the oil macerates with methanol. For quantitation purposes, the chromatographic method was validated using reference standards. This methodology allowed the separation of up to 25 constituents in oily and methanolic SJW extracts, covering hydroxycinnamic acids, flavanols, proanthocyanidins, flavonol glycosides, flavonol aglyca, biflavones, bisanthraquinone glycosides, naphthodianthrones and phloroglucinols. Lowest naphthodianthrone contents were determined in oil macerates recovered at 5 °C, whereas highest amounts were detected upon extraction at 50 °C (both under the exclusion of light). Color shades of the oil macerates differed markedly, revealing e. g. a*-values ranging from -4.6±0.3 to 42.5±0.3. The flavonoids quercetin, kaempferol and I3, II8-biapigenin as well as the phloroglucinols hyperforin and adhyperforin could be simultaneously detected and quantitated in all oil macerates. Contents of these constituents varied noticeably between macerates prepared under different conditions (quercetin 14.7±1.2 to 21.8±0.6 µg/g, kaempferol 3.0±0.1 to 5.4±0.4 µg/g, I3, II8-biapigenin 4.4±0.2 to 7.4±0.4 µg/g, hyperforin 52.6±46.0 to 451.4±24.9 µg/g, adhyperforin 6.9±5.7 to 74.5±7.1 µg/g). These results confirm that the quality of the resulting plant extracts is largely determined by the respective process parameters, i.e. especially temperature and light conditions, and thus must be thoroughly chosen and monitored to obtain tailor-made preparations.
Pharmazie 2017 Mar 1;72(3):131-138. doi: 10.1691/ph.2017.6749. PMID: 29442047 pubmed.ncbi.nlm.nih.gov