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

Combining sertraline with St. John's Wort raises the risk of serotonin syndrome -- named directly on sertraline's FDA label.

Use cautionEvidence: High

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

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

Sertraline Hydrochloride Tablets — FDA Prescribing Information — Via DailyMed, U.S. National Library of Medicine

Last reviewed 2026-08-22

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.

Related guides

SSRIs and Supplement Interaction Cautions