The genus has a nearly worldwide distribution, missing only from tropical lowlands, deserts and polar regions. All members of the genus may be referred to as St. John's wort, though they are also commonly just called hypericum, and some are known as tutsan. The marsh St. John's-worts are nowadays separated into the genus Triadenum.
Hypericums vary from herbaceousannual or perennials 5–10 cm tall to shrubs and small trees up to 12 m tall. The leaves are opposite, simple oval, 1–8 cm long, either deciduous or evergreen. The flowers vary from pale to dark yellow, and from 0.5–6 cm in diameter, with five (rarely four) petals, most having prominent stamens. The fruit is usually a dry capsule which splits to release the numerous small seeds; in some species it is fleshy and berry-like.
H. perforatum is the most potent species and it is today grown commercially for use in herbalism and medicine; other St. John's-worts possess interesting properties and chemical compounds but are not well researched. As these secondary compounds appear to be related to deterring herbivores, they are present in varying and unpredictable quantities: still, a number of high-yield cultivars have been developed.
Two main compounds of interest have been studied in more detail: hyperforin and hypericin. However, the pharmacology of H. perforatum is not resolved, and at least its antidepressant properties are caused by a wide range of factors interacting. As psychiatric medication, it is usually taken as pills, or as tea. Standardised preparations are available, and research has mainly studied alcoholic extracts and isolated compounds. What research data exists supports a noticeable effect in many cases of light and medium depression, but no significant improvement of severe depression and OCD.
The red, oily extract of H. perforatum may help heal wounds. Both hypericin and hyperforin are reported to have antibiotic properties. Justifying this view with the then-current doctrine of signatures, herbalist William Coles (1626–1662) wrote in the 17th century that
"The little holes where of the leaves of Saint Johns wort are full, doe resemble all the pores of the skin and therefore it is profitable for all hurts and wounds that can happen thereunto."
Hypericum perforatum may also be capable of reducing the physical signs of opiate withdrawal. Caution should be taken, as high-dosage H. perforatum interacts with a wide range of medications due to activation of the Pregnane X receptor detoxification pathway, and it also causes photosensitivity.
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