This question could just as easily be asked in relation to any other anti-depressant. In one form or another, it is one of the more common questions on the mind of anyone who has felt the benefit of an anti-depressant medication. The relief and gratitude experience is counterbalanced in many people by a sense of unease at having to be on a medication for an undefined and possibly indefinite period of time. The honest answer is that we just can’t predict how long someone will need to be on an anti-depressant. If the depression has been a single short-lived episode, it may be possible to stop the anti-depressant after six months of remission without risking relapse. If there is a history of repeated episodes or long-standing depression, however, there is a high likelihood that depression will recur or relapse if the anti-depressant is stopped. In such people it generally makes good sense to stay on an antidepressant indefinitely. Although there have been no long-term studies of St John’s Wort in depression – and I should say that such studies are few and far between for other anti-depressants as well – there is no evidence of any long-term problems in those who have been on St John’s Wort for months or even years.
After several months on treatment, people often experiment and stop their anti-depressants just to make sure that they still really need them. If you do this, be sure to watch out for early signs of relapse and return to the anti-depressant as soon as these appear. It is much easier to reverse the symptoms of depression in their initial stages than after they are fully established again.
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