Interactions and Uses of St. John's Wort and Valerian

St. John's wort + MAOIs

Concurrent use may cause hypertensive crisis or serotonin syndrome due to additive effects on serotonin and norepinephrine.

St. John's wort + alcohol

Increases risk of CNS depression and excessive sedation; should be avoided.

St. John's wort + opioids

May increase risk of sedation, respiratory depression, and serotonin syndrome (especially with drugs like tramadol).

St. John's wort + prescription antidepressants

High risk of serotonin syndrome — life-threatening condition with confusion, agitation, hyperthermia, and muscle rigidity.

St. John's wort + sympathomimetics

Can lead to excessive stimulation, hypertension, and tachycardia due to additive sympathomimetic effects.

St. John's wort — primary mental health use

Used for mild to moderate depression due to its effect on serotonin, dopamine, and norepinephrine.

St. John's wort — can it help with nervousness?

Yes — sometimes used to relieve anxiety and nervous tension.

St. John's wort — possible use related to infections?

Has been used as a supportive herbal remedy for some viral infections (e.g., herpes simplex).

St. John's wort — sleep-related benefit

May help with insomnia by promoting calm and relaxation.

St. John's wort — use for women's health

Used to help relieve premenstrual syndrome (PMS) symptoms such as mood swings and irritability.

St. John's wort — topical musculoskeletal use

Applied topically to relieve myalgia (muscle pain).

St. John's wort — topical effect on the skin

Used externally to help reduce inflammation and promote healing of minor wounds and irritations.

Valerian — primary nighttime use

Helps promote sleep and reduce insomnia by calming the nervous system.

Valerian — benefit for overactive behavior

Sometimes used to reduce hyperactivity, especially in people who have trouble calming down.

Valerian — effect during stressful times

Used as an herbal remedy to manage stress and promote relaxation.

Valerian — mental health benefit

Helps to ease mild anxiety and nervous tension.

Valerian + barbiturates

Causes additive sedative effects, increasing risk of CNS depression.

Valerian + other calming herbs

May potentiate sedative effects of herbs like catnip, hops, kava, kona, and passionflower.

Valerian + alcohol

Possibly enhances alcohol's sedative effects, leading to excessive drowsiness or respiratory depression.

Valerian use in pregnancy & breastfeeding

Contraindicated — safety not established for pregnant or breast-feeding patients.

Signs of valerian toxicity

Difficulty walking, hypothermia, increased muscle relaxation.

Rare adverse reaction when stopping valerian

Possible hepatotoxic effects (liver toxicity) upon withdrawal.