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Hypericum perforatum is a medicinal plant commonly known as St. John’s wort. It has been used for centuries to treat various conditions, most notably mild to moderate depression[1][2][4]. The primary active constituents are hypericin and hyperforin (phloroglucinols), along with flavonoids such as quercetin and rutin[4]. Its mechanism of action is multifactorial and includes inhibition of the reuptake of serotonin, dopamine, and norepinephrine; inhibition of monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT); modulation of GABA-A and GABA-B receptors; activation of pregnane-X-receptor; and possible antioxidant effects[6][8]. Standardization is typically based on the content of hypericin or hyperforin[4]. While widely available as an over-the-counter supplement for mood disorders in many countries, it interacts with numerous medications due to its induction of cytochrome P450 enzymes.
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