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Head-to-head evidence comparison — which supplement is right for you?
St. John's Wort wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Likely helps
4 of 4 studies with measurable effects showed benefit.
Top outcomes
Verdict
Mixed evidence
4 of 9 studies with measurable effects showed benefit.
Top outcomes
800-2400mg daily in divided doses
Morning and early afternoon, Divided into 2-3 doses, With choline source
Oxiracetam powder or capsules
300mg 3x daily (900mg total)
With meals, Divided into 2-3 doses
Standardized extract (0.3% hypericin)
1-2 weeks
1-2 weeks
1-2 weeks
If choline-deficient
4-6 weeks
4-8 weeks
During use
First 1-2 weeks
Clinical efficacy and safety of nicergoline combined with oxiracetam in the treatment of vascular cognitive impairment
Pakistan journal of pharmaceutical sciences (2020) · Rct · n=120
The combined group had the highest effective rate and the total effective rate was 93.3%.
A Meta-Analysis of Au/Polypropionic Acid Nanoparticles Loaded with Olacetam for the Treatment of Vascular Cognitive Impairment
Journal of nanoscience and nanotechnology (2020) · Meta analysis
The results of the meta-analysis showed that compared with placebo and other medications, oxiracetam significantly improved the mental status of patients, Concise Mental State Checklist score [mean difference (MD)= 5.29, P < 0.01] and Montreal Cognitive Assessment score (MD = 4.32, P < 0.01).
The treatment of cognitive dysfunction in dementia: a multiple treatments meta-analysis
Psychopharmacology (2018) · Meta analysis · n=44854
The pooled standardized mean difference of the treatment effects on cognitive dysfunction was 0.439 (95% confidence interval 0.374, 0.504).
St John's wort for major depression
Cochrane Database of Systematic Reviews (2008) · Meta analysis · n=5489
As effective as standard antidepressants for mild-moderate depression
Efficacy of Pharmacological Interventions in Milder Depression: A Systematic Review and Meta-Analysis
Neuropsychopharmacology reports (2025) · Meta analysis · n=1049
A meta-analysis found no significant difference in response rates between the two treatments (risk ratio [RR] = 0.96, 95% CI: 0.78-1.18) or dropout rates (RR = 1.08, 95% CI: 0.62-1.88).
Systematic Review and Network Meta-Analysis of the Effects of Plant Extracts on Cognitive Function and Quality of Life in Stroke Patients
Phytotherapy research : PTR (2025) · Meta analysis
John's Wort extract (SUCRA 71.2%) was the most effective in reducing NIHSS scores, Berberine (SUCRA 84.1%) was most effective in reducing mRS scores, and St.
Based on multiple meta-analyses showing cognitive improvements in vascular dementia and stroke populations. One major RCT (n=500) showed no benefit for post-stroke cognitive impairment, limiting confidence. Effects may be population-specific and less pronounced in healthy individuals.
Based on multiple meta-analyses (n>5000) showing efficacy comparable to SSRIs for mild-moderate depression. Effect plateau around 900-1200mg. Not effective for severe depression. Requires standardized extract (0.3% hypericin).
AI-estimated from published studies. Interpret as directional guidance.
St. John's Wort has a higher evidence score (7.8/10 vs 5/10) and wins in 2 of 3 categories.
No known interactions between Oxiracetam and St. John's Wort have been documented in our database. However, always consult a healthcare provider before combining supplements.