How Is St. John's Wort Used for Anxiety?

Hypericum olympicum
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St. John’s Wort (Hypericum perforatum) is an herbal medicine that has historically been used for treating various mental disorders and physical ailments, most notably depression. St. John’s Wort is usually taken daily in pill form.

Dosage Guidelines

In studies of social anxiety disorder, the typical dosage ranges from 600 to 1800 milligrams of St. John’s Wort daily. However, because ingredients can vary, doses may also vary. Before taking St. John’s Wort, you should read the product label and discuss the dose with a qualified healthcare provider.


There is not enough scientific evidence to recommend the use of St. John’s Wort for children under 18 years of age or for women who are pregnant or breastfeeding. St. John’s Wort also has the potential to interact with many other medications, herbs, and supplements and may not be recommended in those cases.

Medication Interactions

St. John’s Wort interferes with the way the body processes or breaks down many medications, herbs, and supplements. It may speed up or slow down this process causing increased or decreased effects, adverse reactions, or increased side effects.

The medications that may potentially interact with St. John’s Wort include, but are not limited to the following:

  • Birth control pills
  • Cancer drugs, such as Irinotecan
  • Cyclosporine (used to prevent the body from rejecting transplanted organs)
  • Digoxin (strengthens heart muscle contractions)
  • HIV drugs, such as Indinavir
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants
  • Warfarin and related anticoagulants

In general, check the package insert and speak with a qualified healthcare professional and/or pharmacist about possible interactions.

Side Effects

The most common side effects of St. John’s Wort are sensitivity to sunlight, restlessness or anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue/sedation, headache, sexual dysfunction, and skin reactions.

Generally, only a small percentage of people will experience side effects and the side effects tend to be less than those associated with standard antidepressant medication. Speak with a healthcare provider immediately if you experience any side effects.

Risks and Effectiveness

The U.S. Food and Drug Administration does not regulate the production of herbs and supplements. Although there are known medication interactions for St. John’s Wort, most herbs, and supplements are not thoroughly tested. There is also no guarantee regarding the ingredients or safety of the product.

Current research suggests that St. John’s Wort is useful in treating mild to moderate depression. However, the usefulness of St. John’s Wort as a primary treatment for anxiety has not been established.

A 2005 study on the effectiveness of St. John’s Wort in treating social anxiety disorder (SAD) found that patients who took the medicine didn’t improve any more than patients who took a placebo.

Uses for Social Anxiety Disorder

Given that no research evidence exists to support the use of St. John's Wort in treating SAD, its usefulness for this purpose is questionable. However, if you suffer from depression in addition to social anxiety disorder, you may experience some benefit.

As a bottom line, if you have been diagnosed with SAD, be sure to consult with your healthcare professional about effective primary treatment methods, such as cognitive-behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs).

Other Supplements for SAD

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Center for Complementary and Alternative Medicine. Herbs at a glance: St. John’s Wort. September 24, 2017.

  2. Kobak KA, Taylor LV, Warner G, Futterer R. St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study. J Clin Psychopharmacol. 2005;25(1):51-8. doi:10.1097/

  3. Sarris J, Kavanagh DJ. Kava and St. John's Wort: current evidence for use in mood and anxiety disorders. J Altern Complement Med. 2009;15(8):827-36. doi:10.1089/acm.2009.0066

  4. Chrubasik-hausmann S, Vlachojannis J, Mclachlan AJ. Understanding drug interactions with St John's wort (Hypericum perforatum L.): impact of hyperforin content. J Pharm Pharmacol. 2019;71(1):129-138. doi:10.1111/jphp.12858

By Arlin Cuncic, MA
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology.