From what is known about hypericum and prescription antidepressants, certain guidelines can be established. Do not stop taking prescription antidepressants without proper medical care. Not enough research has been done on hypericum and these types of depression. As we've said, the vast majority of depressions fall in the mild to moderate range. A depression must be clearly debilitating to be termed severe.
Severe depression can include hallucinations and, in some cases, suicide attempts.
It may require hospitalization. The physician who prescribed the antidepressants or who is currently monitoring the course of treatment is the best person to determine whether one is severely depressed. Combining an SRI with an MAO inhibitor can produce a dangerous rise in blood pressure. This caution, however, is not based on specific medical research on hypericum and MAO inhibitors, but on what is known about prescription SRIs and MAO inhibitors. Until further research is done on how and why hypericum works to alleviate the symptoms of depression, hypericum should be considered an SRI and treated accordingly.