Can I Take These?

Can You Take Escitalopram and St. John's Wort Together?

Escitalopram's FDA label names St. John's Wort by name as raising serotonin syndrome risk.

Use cautionEvidence: High

See the full Escitalopram page and St. John's Wort page for other reviewed interactions and reference information.

What the interaction means

Escitalopram's FDA prescribing information states, discussing serotonin syndrome: "The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John's Wort)." Its Drug Interactions section repeats this, naming "St. John's Wort" again among other serotonergic drugs. Escitalopram's own MedlinePlus page separately confirms: "the following nonprescription or herbal products may interact with escitalopram: aspirin, ibuprofen (Advil, Motrin IB), naproxen (Aleve), St. John's wort, or tryptophan." NCCIH's St. John's Wort page independently corroborates the general risk in less drug-specific terms: "taking St. John's wort with certain antidepressants or other drugs that affect serotonin may lead to increased serotonin-related side effects, which can be serious."

Why it may happen

St. John's Wort has serotonergic activity of its own. Combined with an SSRI like escitalopram, which also increases serotonin activity, the combined effect can raise the risk of serotonin syndrome, a potentially serious condition.

Practical context

This is a specific, current, primary FDA-label finding naming both the medication and the herbal supplement directly, not a class-level generalization. Because serotonin syndrome can be serious, this combination is worth discussing with the prescriber managing escitalopram before starting, stopping, or changing a St. John's Wort supplement.

What the sources say

Escitalopram — MedlinePlus, U.S. National Library of MedicineSt. John's Wort — National Center for Complementary and Integrative Health (NIH)LEXAPRO (escitalopram) Tablets and Oral Solution — FDA Prescribing Information — Allergan, Inc. (via DailyMed, U.S. National Library of Medicine)

Last reviewed 2026-08-24

Medical information disclaimer: this information is general and educational. It does not diagnose conditions, prescribe treatment, or determine whether a combination is safe for you personally. Follow your prescription label and ask a pharmacist or clinician before starting, stopping, or combining products. Full disclaimer.

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