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November 11, 1998

St John's Wort During Pregnancy

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(18):1566. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-18-jbk1111

To the Editor.— With St John's wort (Hypericum perforatum) gaining popularity as a nonprescription, herbal treatment for depression we are concerned that women may assume that it is safe to take during pregnancy.

Review of MEDLINE and Reproductive Toxicity Review using the search terms St John's wort, Hypericum perforatum, hypericin, and Johanneskraut (German) revealed scant information. Increased uterine tonicity has been reported in animals,1 suggesting that use of this agent should be avoided during pregnancy.2 However, a study of toxic effects in rats and dogs at oral doses of 900 and 2700 mg/kg showed no reproductive effects.3 Also, a study of the mutagenic potential of hypericum extract on mammalian cells showed no effects.4 To date, there are no published cases, to our knowledge, of human antenatal exposure or lactation effects.

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