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

What the interaction means

Sertraline's FDA prescribing information states, discussing serotonin syndrome: "The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John's Wort)."

Why it may happen

St. John's Wort has serotonergic activity of its own. Combined with an SSRI like sertraline, 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 sertraline before starting, stopping, or changing a St. John's Wort supplement. No spacing interval applies -- this is a concurrent-use pharmacodynamic risk, not an absorption-timing issue.

What the sources say

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• St. John's Wort and Vitamin B12Insufficient evidence
• St. John's Wort and Vitamin KInsufficient evidence
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• St. John's Wort and OmeprazoleInsufficient evidence
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• St. John's Wort and LisinoprilInsufficient evidence
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• St. John's Wort and CaffeineInsufficient evidence
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• St. John's Wort and ProbioticsInsufficient evidence
• St. John's Wort and CreatineInsufficient evidence
• St. John's Wort and MelatoninInsufficient evidence
• St. John's Wort and TurmericInsufficient evidence