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Transition from SRIs to hypericum:
The best way to make the transition to hypericum from SRIs -- Prozac, Paxil, Zoloft, and Effexoris is not known. Medical studies exploring this question are sorely needed. 
If hypericum acts as a serotonin reuptake inhibitor in the same way as prescription SRIs, then it would appear that a gradual introduction of hypericum while tapering off the prescription antidepressant would be in order. 

One must at the same time be careful not to take too many SRIs, to avoid the medical condition known as serotonin syndrome. Here the brain has too much serotonin -- the opposite of what happens in depression -- and symptoms include sweating, agitation, confusion, lethargy, tremor, and muscle jerks. If such symptoms occur, consult your doctor immediately. 
Of course, the possibility always exists that the hypericum may not treat the depression as successfully as the prescription antidepressant. It should not and cannot be assumed, just because one found successful treatment with prescription antidepressants, that hypericum will prove equally successful. A certain percentage of people will not respond to hypericum as well as they responded to prescription antidepressants.

The Recommended Dosage of Hypericum
The optimum dosage of hypericum, based on the majority of medical studies, is 300 mg of hypericum extract three times a day. This 300 mg dosage fits comfortably into a single tablet or capsule. 
One might, for example, take the first 300 mg on arising, the second 300 mg three hours later, and the final 300 mg three hours after that. Some find that taking two 300 mg doses at breakfast and a third at lunch works best. For those who find hypericum is an aid to restful sleep, the doses can be spread throughout the day, saving the final dose for dinner or bedtime. 
As the side effects of hypericum are few even in significantly higher doses, one can, for example, take four 250 mg capsules daily if only 250 mg capsules are available. 
Small children should take a total of 300 mg of hypericum daily, while larger children should take 600 mg per day. For adolescents, the full adult dose is recommended. 
Hypericum's effectiveness in treating depression should not be evaluated until at least six weeks of a 900 mg daily antidepressant dose. As with prescription antidepressants, the effect of hypericum takes place gradually. Studies generally indicate that hypericum takes longer to reach full effectiveness than do prescription antidepressants. 
Hypericum tends to take longer to reach maximum effect in the body than do prescription antidepressants. This may indicate that a gradual building up of hypericum over four to six weeks should precede a significant reduction in the prescription antidepressants. One should not be too anxious for an immediate "cure," as one might expect from aspirin or a decongestant. The best course is to be watchful for possible side effects, take hypericum "as directed," and make an objective evaluation of benefits six weeks after starting. 
It is important to give hypericum a chance. To decide after one or two weeks, "This isn't working for me," and discontinue treatment is ill advised. 
Certainly if side effects occur, you should consult your healthcare provider. Often, the side effects of hypericum -- especially milder side effects disappear on their own as the body becomes accustomed to the hypericum. Sometimes a slight reduction of the dosage is called for while the body adjusts. 
If the symptoms are severe, stop taking hypericum at once and contact your healthcare professional. All symptoms should fade entirely within a few days after you stop. If the side effects of depression become worse or you are having suicidal impulses, please see your doctor immediately. 
After six weeks, one might decide to take slightly more or slightly less hypericum, depending on the results. Hypericum is not a "more is better" herb. The goal is alleviating the symptoms of depression. For most people, this is accomplished with three 300 mg doses per day. 
If a satisfactory effect is not achieved in six weeks, one should consult with a physician and discuss taking a prescription antidepressant instead.
Besides Hypericum effectiveness in treating various types of depression with considerable success, it is also credited with the following:

  • Hypericum ingredients are thought to relieve ulcers and gastritis.

  • The herb is said to soothe the digestive system.

  • The herb was called on as a folk medicine for diarrhea and nausea

  • Bruises and hemorrhoids are said to respond well to it. 

  • It has served as a sedative, painkiller, and analgesic. 

  • The blossoms have been added to sweek oil (a refined olive oil used medicinally) for a soothing dressing for cuts. 

Herbalists credit it with increasing and inducing a sense of well-being. 

Depression > 1 > 2 > 3 > 4

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