A systematic review of St. John's wort for major depressive disorder.
This review found St. John's wort works about as well as an antidepressant for mild to moderate depression but wasn't tested in severe depression — where does mine sit, and what would you recommend given that?
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: The review's own evidence tables record that a substantial share of the included trials were industry-funded, had a manufacturer author, or were supplied with the product by the manufacturer, and that funding was simply unreported for several others. The authors also note that adverse events were poorly reported in the source trials and that none of the studies was designed to detect rare harms — including the drug interactions that are St. John's wort's main danger.
In the United States St. John's wort is sold as a dietary supplement under DSHEA, which means it reaches the shelf without FDA review of efficacy, safety, or potency and the FDA can act only after a problem emerges. It has never been FDA-approved to treat depression or anything else.
A RAND Corporation review of 35 trials in 6,993 patients found St. John's wort produced more treatment responders than placebo (RR 1.53, 95% CI 1.19-1.97, from 18 RCTs in 2,922 people) and worked about as well as antidepressants in mild and moderate depression (RR 1.01, 95% CI 0.90-1.14) with fewer adverse events (OR 0.67, 95% CI 0.56-0.81). Every one of those conclusions was graded only moderate quality because heterogeneity was severe (I-squared 79-89%), and there is essentially no research in severe depression.
Worth asking
This review found St. John's wort works about as well as an antidepressant for mild to moderate depression but wasn't tested in severe depression — where does mine sit, and what would you recommend given that?
Source
A systematic review of St. John's wort for major depressive disorder. — Apaydin EA, Maher AR, Shanman R, Booth MS, Miles JN, Sorbero ME, Hempel S. (2016)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1186/s13643-016-0325-2
DOI: 10.1186/s13643-016-0325-2
How this was scored
- Study design
- Systematic review of randomised trials
- Funding
- Independently funded
- Published in
- Reputable peer-reviewed journal
- Sample size
- 6,993
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 94 out of 100 on our published rubric. One caveat travels with that badge: The review's own evidence tables record that a substantial share of the included trials were industry-funded, had a manufacturer author, or were supplied with the product by the manufacturer, and that funding was simply unreported for several others. The authors also note that adverse events were poorly reported in the source trials and that none of the studies was designed to detect rare harms — including the drug interactions that are St. John's wort's main danger. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
A systematic review of St. John's wort for major depressive disorder. — Apaydin EA, Maher AR, Shanman R, Booth MS, Miles JN, Sorbero ME, Hempel S. (2016). Published in: Reputable peer-reviewed journal. DOI: 10.1186/s13643-016-0325-2. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Systematic review of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is st-johns-wort, hypericum perforatum, sjw, hypericum, klamath weed, tipton's weed, li 160, ws 5570, stw3-vi, ze 117 FDA approved for this use?
No. Its current status is: Not FDA-evaluated for this use. In the United States St. John's wort is sold as a dietary supplement under DSHEA, which means it reaches the shelf without FDA review of efficacy, safety, or potency and the FDA can act only after a problem emerges. It has never been FDA-approved to treat depression or anything else.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.