This is usually temporary and can be helped by acidophilus and psyllium. Occasionally, people may have temporary headaches, although SAM-e often helps headaches. A few people feel a little bit stimulated and may have trouble sleeping. As I mentioned before, if someone has bipolar disorder, they could become manic. There's no problem with sex or weight gain.
People usually have a sense of well-being, which is very different from a lot of other medications.
At doses of 1,800 mg. per day, it can be helpful for more serious depression. However, I find that many patients on it notice upset stomach, jitters, trouble sleeping and are more likely to get a sunburn or rash in the sun. It also can lower the blood levels of many common medicines. Most of the brands on the market are not effective. There are no good, long-term data on the effects of St. Johns wort.