St Johns Wort × Tricyclic Antidepressants

Severity: MODERATE Evidence: probable

Mechanism

St. John's wort induces CYP2C19 and CYP3A4, increasing metabolism of tricyclic antidepressants.

Effect

Reduced antidepressant levels; loss of efficacy

Management

Monitor antidepressant levels. Avoid combination if possible.

Source

Roots I et al. Pharmacopsychiatry 2000

⚠️ MODERATE INTERACTION: Monitor closely if this combination is used.

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.