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Extracts of Hypericum perforatum L. (St. John's wort) have been recommended traditionally for a wide range of medical conditions. The most common modern-day use of St. John's wort is the treatment of depression. Numerous studies report St. John's wort to be more effective than placebo and equally effective as tricyclic antidepressant drugs in the short-term treatment of mild-to-moderate major depression (1-3 months). It is not clear if St. John's wort is as effective as selective serotonin reuptake inhibitor (SSRI) antidepressants such as sertraline (Zoloft®). Recently, controversy has been raised by two high-quality trials of St. John's wort for major depression that did not show any benefits. However, due to problems with the designs of these studies, they cannot be considered definitive. Overall, the scientific evidence supports the effectiveness of St. John's wort in mild-to-moderate major depression. The evidence in severe major depression remains unclear. St. John's wort can cause many serious interactions with prescription drugs, herbs, or supplements. Therefore, people using any medications should consult their healthcare providers including their pharmacist prior to starting therapy.
Valerian is an herb native to Europe and Asia that currently grows in most parts of the world. The name is believed to come from the Latin word "valere" meaning to be healthy or strong. The root of the plant is believed to contain its active constituents. Use of valerian as a sedative and anti-anxiety treatment has been reported for more than 2,000 years. For example, in the 2nd Century AD, Galen recommended valerian as a treatment for insomnia. Related species have been used in traditional Chinese and Indian Ayurvedic medicine. Preparations for use on the skin have been used to treat sores and acne, and valerian by mouth has been used for other conditions such as digestive problems, flatulence (gas), congestive heart failure, urinary tract disorders, and angina (chest pain). Valerian extracts became popular in the United States and Europe in the mid-1800s and continued to be used by both physicians and the lay public until it was widely replaced by prescription sedative drugs. Valerian remains popular in North America, Europe, and Japan and is widely used to treat insomnia and anxiety. Although the active ingredients in valerian are not known, preparations are often standardized to the content of valerenic acid.