General practitioners and St. John's wort: A question of regulation or knowledge?

Background: St. John's Wort (SJW), also known as Hypericum perforatum, is a herbal remedy available over-the-counter. There is evidence that it can treat mild to moderate depression but has potential side effects and important drug interactions. Objective: To determine general practitioners' (GPs') knowledge and recommendation of SJW for mild to moderate depression within a climate of widespread community use of complementary therapies and debate about regulation. Design and setting: Postal survey of a random sample of 350 Australian GPs. Results: Forty-eight percent responded. One-third (31%) reported recommending SJW to patients with mild to moderate depression. Of these, only one-third (32%) reported specific dosage instructions. Respondents' knowledge of side effects and interactions was much less than for selective serotonin reuptake inhibitor antidepressants. Conclusions: Australian GPs know less about safety of SJW than antidepressants and do not widely recommend it to patients. Despite this, many patients use SJW, probably in combination with other pharmaceuticals. Effective dissemination of further research into effectiveness and risk profiles of complementary therapies is needed to inform health professionals, regulatory bodies and consumers. (c) 2006 Elsevier Ltd. All rights reserved.