Karmamood (Hypericum Perforatum Dry Extract (3,5 - 6,0:1), Extract Ethanol 60% (M/M))

• Karmamood, containing Hypericum perforatum dry extract, is used in the context of mood‑related conditions.
• Mild to moderate depression: may help improve mood and reduce depressive symptoms in adults.
• Seasonal affective disorder: may alleviate low mood associated with seasonal changes.
• Stress‑related mood disturbances: may support emotional balance during periods of high stress.
• Anxiety symptoms: may contribute to a feeling of calmness in mild anxiety.
• Sleep quality disturbances: may aid in achieving more restful sleep.

• The exact mechanism of Hypericum perforatum is not fully elucidated, but the extract influences several neurochemical pathways. It inhibits the reuptake of serotonin, dopamine and norepinephrine, increasing their synaptic availability. Flavonoids and hyperforin may also modulate GABAergic activity and provide antioxidant effects, contributing to its mood‑stabilising properties.

Hypericum perforatum dry extract may be associated with a range of adverse reactions, which are categorised by frequency and severity.

Common Side Effects

• Gastrointestinal discomfort: nausea, abdominal cramps or diarrhea.
• Dry mouth: reduced salivation leading to thirst.
• Dizziness or light‑headedness: especially when standing quickly.
• Fatigue or mild drowsiness: transient tiredness.
• Headache: mild to moderate intensity.
• Photosensitivity: increased skin sensitivity to sunlight.

Serious or Rare Side Effects

• Serotonin syndrome: risk when combined with serotonergic drugs, presenting with agitation, tremor, fever.
• Severe allergic reactions: rash, itching, swelling, or anaphylaxis.
• Manic or hypomanic episodes: mood elevation in susceptible individuals.
• Significant liver enzyme elevation: rare hepatic dysfunction.
• Severe photosensitivity burns: intense sunburns after brief exposure.

• When considering Karmamood, several precautionary measures should be observed to ensure safe use.
• Concurrent antidepressants: avoid use with SSRIs, MAO inhibitors or tricyclics to reduce serotonin syndrome risk.
• Sun exposure: limit prolonged sunlight and use protective clothing or sunscreen due to photosensitivity.
• Pregnancy and breastfeeding: safety has not been established; use only if clearly needed.
• Bipolar disorder: may trigger manic episodes; contraindicated in individuals with a history of mania.
• Drug monitoring: patients on anticoagulants or oral contraceptives should be monitored for reduced efficacy.
• Store at ambient temperature below 25°C: keep in the original pack, protect from moisture and light.

Hypericum perforatum can affect the metabolism of several medicines, leading to clinically relevant interactions.

Major Interactions (Avoid)

• SSRIs, SNRIs, tricyclic antidepressants: risk of serotonin syndrome.
• MAO inhibitors: heightened serotonergic activity.
• Oral contraceptives: reduced plasma levels, possible contraceptive failure.
• Anticoagulants (e.g., warfarin): decreased effectiveness, increased clotting risk.
• Immunosuppressants (e.g., cyclosporine): lowered drug concentrations.

Moderate Interactions (Monitor Closely)

• Antiepileptic drugs (phenytoin, carbamazepine): reduced plasma levels.
• HIV protease inhibitors (ritonavir): altered metabolism.
• Chemotherapy agents (e.g., irinotecan): possible efficacy changes.
• Digoxin: decreased serum concentrations.
• Statins (e.g., simvastatin): modest reduction in exposure.