Can I Take st johns wort and antidepressants Together?

SUMMARY:

Taking St. John's wort together with prescription antidepressants can be risky: it may raise the chance of serotonin syndrome with serotonergic antidepressants and can alter blood levels of many antidepressants by inducing liver metabolism. Avoid combining them or change doses only under a clinician’s supervision.

ADDITIONAL NOTES:

Main risks: 1) Serotonin syndrome when combined with SSRIs, SNRIs, TCAs, MAOIs or other serotonergic drugs — watch for agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, tremor/rigidity, sweating, and fever. 2) Enzyme induction (e.g., CYP systems) by St. John's wort can lower plasma concentrations of many antidepressants and other drugs, reducing effectiveness or causing withdrawal/relapse. Interaction severity varies by specific antidepressant; some combinations may be particularly unsafe. Do not start, stop, or change doses of St. John's wort or antidepressants without consulting a prescriber or pharmacist.