Plant Comparison
Perforate St John’s-wort vs Oregon Grape
A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.
At a glance
Perforate St John’s-wort and Oregon Grape: they share 6 indicated uses (arthritis / joint pain, eczema, infection (general), …); 1 pharmacological action in common.
Evidence face-off — shared uses
| Condition | Perforate St John’s-wort | Oregon Grape | Verdict |
|---|---|---|---|
| Arthritis / joint pain | 1/10 | 7/10 | Stronger for Oregon Grape |
| Eczema | 1/10 | 7/10 | Stronger for Oregon Grape |
| Infection (general) | 1/10 | 2/10 | Comparable evidence |
| Inflammation (general) | 1/10 | 7/10 | Stronger for Oregon Grape |
| Skin irritation | 1/10 | 8/10 | Stronger for Oregon Grape |
| Wounds | 1/10 | 1/10 | Comparable evidence |
Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.
Key Constituents
Red pigments historically used to standardise extracts; contribute to antiviral activity and are the compounds responsible for photosensitivity risk.
Considered the principal compound behind the antidepressant activity and the main driver of the herb's potent CYP3A4/P-glycoprotein induction and drug-interaction profile.
Antioxidant flavonoids contributing to overall activity.
Pharmacological Actions
Anti-inflammatory and antiproliferative (slows the skin-cell overgrowth of psoriasis)
Anti-inflammatory and antiproliferative (slows the skin-cell overgrowth of psoriasis)
Traditional & Indicated Uses
inferred from anti-inflammatory action
inferred from antiviral action
inferred from anti-inflammatory action
inferred from sedative action
inferred from anti-inflammatory action
inferred from anti-inflammatory action
inferred from anticancer action
Topical for atopic dermatitis (eczema) and skin irritation
Antimicrobial (berberine) - supports skin and mucosal infection
inferred from anti-inflammatory action
Anti-inflammatory and antiproliferative (slows the skin-cell overgrowth of psoriasis); Topical treatment of mild-to-moderate psoriasis (reduces plaque severity) - a double-blind, placebo-controlled RCT showed significant improvement in PASI and quality-of-life scores
Topical for atopic dermatitis (eczema) and skin irritation
Safety, Cautions & Contraindications
Significant drug interactions: strongly induces CYP3A4 and P-glycoprotein, reducing plasma levels of many drugs including oral contraceptives, antiretrovirals, cyclosporine, warfarin, and digoxin. May cause photosensitivity (fair-skinned individuals). Do not combine with SSRIs, SNRIs, or MAOIs (serotonin syndrome risk). Avoid in bipolar disorder.
Duke (2002) rates St. John's wort as ++ (raised from earlier editions) and notes antidepressant, antiviral, antibacterial, and wound-healing activities at experimental and clinical levels. Hypericin and hyperforin are identified as key active constituents. Clinical evidence (score 2) confirms antidepressant efficacy in mild-to-moderate depression, and WHO/Commission E provide approval for this indication. Dose: 300 mg standardized extract (0.3% hypericin, 3–5% hyperforin) three times daily. Duke emphasizes the critical drug interaction: St. John's wort is a potent CYP3A4 inducer and can significantly reduce blood levels of many medications including oral contraceptives, cyclosporine, antiretrovirals, and warfarin. Avoid combined use with SSRIs (serotonin syndrome risk) and pharmaceutical antidepressants (Duke, 2002).
Avoid internal use in pregnancy and breastfeeding: like goldenseal, the berberine it contains can cross the placenta and into milk and worsen newborn jaundice (kernicterus risk).
External Ids
Botanical Description
Erect, branching perennial herb with paired, oval leaves dotted with tiny translucent oil glands that look like pinpricks when held to the light (giving the species name 'perforatum'). Bright yellow, five-petalled flowers with numerous stamens and black dots along the petal edges are borne in flat-topped clusters, and release a reddish pigment when crushed.[4]
Evergreen shrub, 0.5-2 m tall, spreading by underground rhizomes to form thickets. The pinnate leaves resemble holly, with 5-9 glossy, dark green, spiny-toothed leaflets that often turn bronze-red in winter. Small, bright yellow, six-petalled flowers are borne in dense, upright terminal racemes in early spring, followed by clusters of blue-black, grape-like berries with a waxy bloom. The wood and inner bark of the stem and root are bright yellow when cut, owing to their high content of berberine-type alkaloids.
Habitat
Grows in grassland, roadsides, woodland clearings and waste ground on well-drained soils; native to Europe, Western Asia and North Africa and widely naturalised elsewhere, including North America and Australia.[4]
Native to the Pacific Northwest of North America, growing in coniferous woodland understorey, forest margins and rocky slopes; widely introduced and naturalised as an ornamental and hedging shrub in temperate regions elsewhere.
Harvesting
The flowering tops (flower and upper leaf) are cut in summer as the flowers open, around the traditional St John's Day period, and dried quickly in a warm, shaded, airy place to preserve the hypericin and hyperforin content.[4]
The root and root bark, the medicinal parts, are dug from established plants - traditionally in autumn - and dried. Because wild populations are slow-growing, cultivated or nursery-sourced material is preferred over wild-harvesting.
Traditional Uses
St John's wort has a centuries-long European folk reputation as a wound-healing and nerve tonic herb, traditionally used for mild wounds, burns and nerve pain and to lift low mood; this traditional mood-supporting use is now one of the most extensively clinically studied applications of any herbal medicine, with standardised extracts shown comparable to conventional antidepressants for mild-to-moderate depression.[1, 4]
Oregon grape root has a traditional Native American and Eclectic-medicine history as a bitter tonic and alterative (blood-purifying) remedy and for skin conditions. Its main modern use, supported by clinical trials, is topical application of a standardised bark extract for mild-to-moderate psoriasis and atopic dermatitis (eczema), where its berberine-type alkaloids give anti-inflammatory and antiproliferative effects on skin cells.[1, 11, 12]
Preparations
Flowering-top extract standardised to hypericin and/or hyperforin content, taken as tablets or capsules; the best-studied clinical form for mood support.
Dosage
Clinical trials for mild-to-moderate depression commonly use around 300 mg of standardised extract three times daily (900 mg/day total); given extensive drug interactions, use should be discussed with a healthcare provider, especially alongside other medicines. Educational reference only, not a prescription.
Drug Class Interactions
Not documented
References
Pairings
St John's wort raises serotonin activity and can cause serotonin syndrome when combined with other serotonin-boosting agents; pairing it with another mood-active, serotonergic herb such as saffron may add to this risk.[30]
St John's wort is a strong enzyme inducer and increases serotonin activity; combining it with another antidepressant-type herb such as rhodiola may add to serotonergic effects and unpredictably change how each is handled by the body.[30]
St John's wort speeds up the breakdown of many substances and also raises serotonin activity; pairing it with a sedative herb such as valerian may add to drowsiness and can unpredictably change how each is handled by the body.[30, 31]
St John's wort is a strong enzyme inducer and kava is a liver-metabolised sedative; combining them may add to central-nervous-system effects and alter how kava is processed, so combined use warrants caution.[30, 31]
Not documented
Lookalikes Review
References & Sources
- Ng, Q.X., Venkatanarayanan, N. and Ho, C.Y.X (2017) 'Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis', Journal of Affective Disorders, 210, pp. 211-221. doi:10.1016/j.jad.2016.12.048 Meta-analysis / review
https://doi.org/10.1016/j.jad.2016.12.048 - Kholghi, G., Arjmandi-Rad, S., Zarrindast, M.R. and Vaseghi, S (2022) 'St. John's wort (Hypericum perforatum) and depression: what happens to the neurotransmitter systems?', Naunyn-Schmiedeberg's Archives of Pharmacology, 395(6), pp. 629-642. doi:10.1007/s00210-022-02229-z Traditional / reference
https://doi.org/10.1007/s00210-022-02229-z - Fugh-Berman, A (2000) 'Herb-drug interactions', Lancet, 355(9198), pp. 134-138. doi:10.1016/S0140-6736(99)06457-0 Traditional / reference
https://doi.org/10.1016/S0140-6736(99)06457-0 - Nobakht, S.Z., Akaberi, M., Mohammadpour, A.H., Tafazoli Moghadam, A. and Emami, S.A (2022) 'Hypericum perforatum: Traditional uses, clinical trials, and drug interactions', Iranian Journal of Basic Medical Sciences, 25(9), pp. 1045-1058. doi:10.22038/IJBMS.2022.65112.14338 Meta-analysis / review
https://doi.org/10.22038/IJBMS.2022.65112.14338 - Jiang, Z., Wang, F., Zhao, Y., Lu, L., Jiang, X., Huang, T., Lin, Y., Guo, L., Weng, Z. and Liu, E (2024) 'Hypericum perforatum L. attenuates depression by regulating Akkermansia muciniphila, tryptophan metabolism and NFkB-NLRP2-Caspase1-IL1beta pathway', Phytomedicine, 132, pp. 155847. doi:10.1016/j.phymed.2024.155847 Preclinical
https://doi.org/10.1016/j.phymed.2024.155847 - Oliveira, A.I., Pinho, C., Sarmento, B. and Dias, A.C.P (2016) 'Neuroprotective Activity of Hypericum perforatum and Its Major Components', Frontiers in Plant Science, 7, pp. 1004. doi:10.3389/fpls.2016.01004 Meta-analysis / review
https://doi.org/10.3389/fpls.2016.01004 - Russo, E., Scicchitano, F., Whalley, B.J., Mazzitello, C., Ciriaco, M., Esposito, S., Patane, M., Upton, R., Pugliese, M., Chimirri, S., Mammi, M., Palleria, C. and De Sarro, G (2013) 'Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions', Phytotherapy Research, 28(5), pp. 643-655. doi:10.1002/ptr.5050 Meta-analysis / review
https://doi.org/10.1002/ptr.5050 - Saddiqe, Z., Naeem, I. and Maimoona, A (2010) 'A review of the antibacterial activity of Hypericum perforatum L', Journal of Ethnopharmacology, 131(3), pp. 511-521. doi:10.1016/j.jep.2010.07.034 Meta-analysis / review
https://doi.org/10.1016/j.jep.2010.07.034 - Mennini, T. and Gobbi, M (2004) 'The antidepressant mechanism of Hypericum perforatum', Life Sciences, 75(9), pp. 1021-1027. doi:10.1016/j.lfs.2004.04.005 Meta-analysis / review
https://doi.org/10.1016/j.lfs.2004.04.005 - Liu, Y., Jiang, Y., Huang, R., Yang, J., Xiao, B. and Dong, J (2013) 'Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety', Climacteric, 17(4), pp. 325-335. doi:10.3109/13697137.2013.861814 Meta-analysis / review
https://doi.org/10.3109/13697137.2013.861814 - Wurglics, M. and Schubert-Zsilavecz, M (2006) 'Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients', Clinical Pharmacokinetics, 45(5), pp. 449-468. doi:10.2165/00003088-200645050-00002 Meta-analysis / review
https://doi.org/10.2165/00003088-200645050-00002 - Kasper, S (2001) 'Hypericum perforatum - a review of clinical studies', Pharmacopsychiatry, 34(Suppl 1), pp. S51-S55. doi:10.1055/s-2001-15467 Meta-analysis / review
https://doi.org/10.1055/s-2001-15467 - Nathan, P (1999) 'The experimental and clinical pharmacology of St John's Wort (Hypericum perforatum L.)', Molecular Psychiatry, 4(4), pp. 333-338. doi:10.1038/sj.mp.4000557 Meta-analysis / review
https://doi.org/10.1038/sj.mp.4000557 - Verotta, L (2003) 'Hypericum perforatum, a source of neuroactive lead structures', Current Topics in Medicinal Chemistry, 3(2), pp. 187-201. doi:10.2174/1568026033392589 Meta-analysis / review
https://doi.org/10.2174/1568026033392589 - Linde, K. et al (2008) 'St John'. Traditional / reference
https://scholar.google.com/scholar?q=St%20John - Natural Standard (2013) 'Hypericum perforatum (St'. Traditional / reference
https://scholar.google.com/scholar?q=Hypericum%20perforatum%20%28St - Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition - Zhou, S., Chan, E., Pan, S.Q., Huang, M. and Lee, E.J.D (2004) 'Pharmacokinetic interactions of drugs with St John's wort', Journal of Psychopharmacology, 18(2), pp. 262-276. doi:10.1177/0269881104042632 Meta-analysis / review
https://doi.org/10.1177/0269881104042632 - Izzo, A.A. and Ernst, E (2009) 'Interactions between herbal medicines and prescribed drugs: an updated systematic review', Drugs, 69(13), pp. 1777-1798. doi:10.2165/11317010-000000000-00000 Meta-analysis / review
https://doi.org/10.2165/11317010-000000000-00000 - Borrelli, F. and Izzo, A.A (2009) 'Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations', The AAPS Journal, 11(4), pp. 710-727. doi:10.1208/s12248-009-9146-8 Meta-analysis / review
https://doi.org/10.1208/s12248-009-9146-8 - Nicolussi, S., Drewe, J., Butterweck, V. and Meyer zu Schwabedissen, H.E (2020) 'Clinical relevance of St. John's wort drug interactions revisited', British Journal of Pharmacology, 177(6), pp. 1212-1226. doi:10.1111/bph.14936 Meta-analysis / review
https://doi.org/10.1111/bph.14936 - Piscitelli, S.C., Burstein, A.H., Chaitt, D., Alfaro, R.M. and Falloon, J (2000) 'Indinavir concentrations and St John's wort', Lancet, 355(9203), pp. 547-548. doi:10.1016/S0140-6736(99)05712-8 Clinical study
https://doi.org/10.1016/S0140-6736(99)05712-8 - Barone, G.W., Gurley, B.J., Ketel, B.L., Lightfoot, M.L. and Abul-Ezz, S.R (2000) 'Drug interaction between St. John's wort and cyclosporine', Annals of Pharmacotherapy, 34(9), pp. 1013-1016. doi:10.1345/aph.10088 Clinical study
https://doi.org/10.1345/aph.10088 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Pfrunder, A., Schiesser, M., Gerber, S., Haschke, M., Bitzer, J. and Drewe, J (2003) 'Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial', British Journal of Clinical Pharmacology, 56(6), pp. 683-690. doi:10.1046/j.1365-2125.2003.02005.x Randomized trial
https://doi.org/10.1046/j.1365-2125.2003.02005.x - Johne, A., Brockmoller, J., Bauer, S., Maurer, A., Langheinrich, M. and Roots, I (1999) 'Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)', Clinical Pharmacology and Therapeutics, 66(4), pp. 338-345. doi:10.1053/cp.1999.v66.a101944 Clinical study
https://doi.org/10.1053/cp.1999.v66.a101944 - Mathijssen, R.H.J., Verweij, J., de Bruijn, P., Loos, W.J. and Sparreboom, A (2002) 'Effects of St. John's wort on irinotecan metabolism', Journal of the National Cancer Institute, 94(16), pp. 1247-1249. doi:10.1093/jnci/94.16.1247 Randomized trial
https://doi.org/10.1093/jnci/94.16.1247 - Smith, P., Bullock, J.M., Booker, B.M., Haas, C.E., Berenson, C.S. and Jusko, W.J (2004) 'The influence of St. John's wort on the pharmacokinetics and protein binding of imatinib mesylate', Pharmacotherapy, 24(11), pp. 1508-1514. doi:10.1592/phco.24.16.1508.50958 Clinical study
https://doi.org/10.1592/phco.24.16.1508.50958 - Izzo, A.A (2004) 'Drug interactions with St. John's Wort (Hypericum perforatum): a review of the clinical evidence', International Journal of Clinical Pharmacology and Therapeutics, 42(3), pp. 139-148. doi:10.5414/cpp42139 Meta-analysis / review
https://doi.org/10.5414/cpp42139 - Caus, M.N., Lupoae, M. and Chitescu, C.L (2026) 'Efficacy and Safety of Herbal Supplements with Anxiolytic, Antidepressant, and Sedative Action: A Review of Clinical Data and Toxicological Risks', Pharmaceuticals, 19(3), pp. 399. doi:10.3390/ph19030399 Meta-analysis / review
https://doi.org/10.3390/ph19030399
- Gulliver, W.P. and Donsky, H.J (2005) 'A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis', American Journal of Therapeutics, 12(5), pp. 398-406. doi:10.1097/01.mjt.0000174350.82270.da Clinical study
https://doi.org/10.1097/01.mjt.0000174350.82270.da - Cernakova, M. and Kostalova, D (2002) 'Antimicrobial activity of berberine--a constituent of Mahonia aquifolium', Folia Microbiologica, 47(4), pp. 375-378. doi:10.1007/BF02818693 Preclinical
https://doi.org/10.1007/BF02818693 - Damjanovic, A., Kolundzija, B., Matic, I.Z., Krivokuca, A. and others (2020) 'Mahonia aquifolium Extracts Promote Doxorubicin Effects against Lung Adenocarcinoma Cells In Vitro', Molecules, 25(22), pp. 5233. doi:10.3390/molecules25225233 Preclinical
https://doi.org/10.3390/molecules25225233 - Cernakova, M., Kostalova, D., Kettmann, V., Plodova, M. and others (2002) 'Potential antimutagenic activity of berberine, a constituent of Mahonia aquifolium', BMC Complementary and Alternative Medicine, 2, pp. 2. doi:10.1186/1472-6882-2-2 Preclinical
https://doi.org/10.1186/1472-6882-2-2 - Slobodnikova, L., Kostalova, D., Labudova, D., Kotulova, D. and Kettmann, V (2004) 'Antimicrobial activity of Mahonia aquifolium crude extract and its major isolated alkaloids', Phytotherapy Research, 18(8), pp. 674-676. doi:10.1002/ptr.1517 Preclinical
https://doi.org/10.1002/ptr.1517 - Godjevac, D., Damjanovic, A., Stanojkovic, T.P., Andjelkovic, B. and Zdunic, G (2018) 'Identification of cytotoxic metabolites from Mahonia aquifolium using 1H NMR-based metabolomics approach', Journal of Pharmaceutical and Biomedical Analysis, 150, pp. 9-14. doi:10.1016/j.jpba.2017.11.075 Preclinical
https://doi.org/10.1016/j.jpba.2017.11.075 - Muller, K. and Ziereis, K (1994) 'The antipsoriatic Mahonia aquifolium and its active constituents; I. Pro- and antioxidant properties and inhibition of 5-lipoxygenase', Planta Medica, 60(5), pp. 421-424. doi:10.1055/s-2006-959523 Preclinical
https://doi.org/10.1055/s-2006-959523 - Rohrer, U., Kunz, E.M.K., Lenkeit, K., Schaffner, W. and Meyer, J (2007) 'Antimicrobial activity of Mahonia aquifolium and two of its alkaloids against oral bacteria', Schweizer Monatsschrift fur Zahnmedizin, 117(11), pp. 1126-1131. Preclinical
https://scholar.google.com/scholar?q=Antimicrobial%20activity%20of%20Mahonia%20aquifolium%20and%20two%20of%20its%20alkaloids%20against%20oral%20bacteria - Vollekova, A., Kostalova, D., Kettmann, V. and Toth, J (2003) 'Antifungal activity of Mahonia aquifolium extract and its major protoberberine alkaloids', Phytotherapy Research, 17(7), pp. 834-837. doi:10.1002/ptr.1256 Preclinical
https://doi.org/10.1002/ptr.1256 - Hajnicka, V., Kostalova, D., Svecova, D., Sochorova, R. and others (2002) 'Effect of Mahonia aquifolium active compounds on interleukin-8 production in the human monocytic cell line THP-1', Planta Medica, 68(3), pp. 266-268. doi:10.1055/s-2002-23126 Preclinical
https://doi.org/10.1055/s-2002-23126 - Gulliver, W.P. and colleagues (2018) 'Review of the Efficacy and Safety of Topical Mahonia aquifolium for the Treatment of Psoriasis and Atopic Dermatitis', Journal of Clinical and Aesthetic Dermatology. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334833/ Meta-analysis / review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334833/ - Herbal Reality (n.d.) 'Oregon Grape Root (Berberis aquifolium): Benefits, Uses, Safety'. Available at: https://www.herbalreality.com/herb/oregon-grape/ Traditional / reference
https://www.herbalreality.com/herb/oregon-grape/ - Bernstein, S., Donsky, H., Gulliver, W., Hamilton, D., Nobel, S. and Norman, R (2006) 'Treatment of mild to moderate psoriasis with Relieva, a Mahonia aquifolium extract - a double-blind, placebo-controlled study', American Journal of Therapeutics, 13(2), pp. 121--126. doi:10.1097/00045391-200603000-00007 Randomized trial
https://doi.org/10.1097/00045391-200603000-00007
Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.