St. John’s Wort is an herb that many people use to treat depression. Research into the effectiveness of St. John's wort has produced varied results, with some groups claiming it is extremely effective and others claiming that it is not. However, St. John’ Wort has never been studied specifically for depression in people with MS, which may have a different mechanism than depression in people without MS.
For those of you using St. John's wort to treat MS-related depression, just a gentle reminder: St. John's wort can potentially interfere with the effectiveness of oral contraceptives by lowering the concentration of them in the blood. In other words, your birth control pills will not work as well if you are taking St. John's wort, and you may get pregnant.
This is especially important information if you (or your female partner with MS) are currently on disease-modifying therapies and using birth control pills to prevent pregnancy. The current MS treatments are all category C, meaning they have been shown to cause problems in fetuses in animal studies, but have not been studied adequately in humans (the exception to this is Copaxone, which is category B). Doctors usually recommend that women stop treatment for about three months before trying to conceive, in order to let the medication clear from the body. Therefore, it is inadvisable for any woman currently on therapy to get pregnant as it could result in fetal damage or miscarriage.
Anyway, I would presume that anyone using contraceptives, whether on MS treatment or not, is counting on them working. Therefore, I wanted to mention this little tidbit about St. John's wort in the hopes of preventing any little (big) surprises, which have been referred to as “Little St. Johns.”
Source: MedlinePlus. St. John’s wort (Hypericum perforatum L.).
Bowling, Allen C. Complementary and Alternative Medicine and Multiple Sclerosis. 2nd Ed. New York: Demos Publishing. 2007.
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