A careful reading of the hypericum section, however, revealed that several newer clinical trials were not included, while an old (1994) study remained.

In this reference, the physician would learn St. John's wort taken concomitantly with sertraline may lead to "serotonin syndrome," e.g., sweating, tremor, flushing, confusion and agitation. The likelihood of seeing this effect would be difficult to judge, however, since these anecdotal reports from the literature are taken a face value with little critical appraisal. If we don't know how many patients have taken this particular combination, we have no denominator. The inclusion of all material related to toxicologic effects is good for the sake of a comprehensive overview, but the drawback is to lose the feel for what may really be important.