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St. John's wort + kava is a combination of two herbal supplements—St. John's wort (Hypericum perforatum) and kava (Piper methysticum)—used primarily for mood disorders such as depression and anxiety. St. John's wort is known for its antidepressant effects, attributed to active constituents like hypericin and hyperforin, which inhibit the reuptake of neurotransmitters including serotonin, norepinephrine, and dopamine[2][3]. Kava contains kavalactones that exert anxiolytic effects mainly through modulation of GABAergic activity in the central nervous system[2][3]. The combination has been studied in at least one randomized controlled trial for major depressive disorder with comorbid anxiety; results showed some evidence of antidepressant effect but not significant anxiolysis[1][7]. Both herbs have notable potential for drug interactions due to their influence on cytochrome P450 enzymes and other pharmacodynamic pathways[2][6].
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