Interaction: St Johns Wort × Ssri
St Johns Wort × Ssri
Severity: CRITICAL Evidence: well-established
Mechanism
St. John's wort inhibits serotonin reuptake and induces CYP enzymes that metabolize SSRIs. Combined use risks serotonin syndrome.
Effect
Serotonin syndrome (agitation, confusion, tachycardia, hyperthermia); also reduced SSRI efficacy via enzyme induction
Management
Avoid combination. Serotonin syndrome can be life-threatening. Allow 2-week washout between St. John's wort and SSRIs.
Source
FDA MedWatch; Nemeroff CB et al. J Clin Psychiatry 2005
⚠️ CRITICAL INTERACTION: This combination should be AVOIDED.
Disclaimer
This interaction record is for informational purposes only and does not constitute medical advice. Always consult a healthcare provider before starting or stopping any supplement or medication.