★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.
It is a shelf supplement in America and a prescription elsewhere
The national liver-injury monograph records it as available over the counter in the United States while being actively prescribed for mild to moderate depression in other countries.
What the study found
Sold off the shelf in America, prescribed for depression elsewhere
The same product is a supplement in one country and a prescription antidepressant in another. The national liver-injury monograph records St John's Wort as available over the counter in the United States while being actively prescribed for mild to moderate depression in other countries.
The caveat · Names no country on either side
The monograph states this qualitatively and names no country on either side, so it establishes that prescription status varies internationally without documenting where. Its references were last updated in 2020.