Medication · Medication
SSRIs & SNRIs
Selective serotonin (and serotonin-norepinephrine) reuptake inhibitors — first-line drugs for depression and anxiety.
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A medication reference built from the interaction graph. It is not prescribing information — the label and your prescriber are.
What is uncertain
Read off the same rows as above. Nothing here is added that the entry does not itself record.
- Caution with St. John's Wort: Serotonin-syndrome risk — never combine.
- Caution with Saffron: Serotonergic — additive load; clear with prescriber.
- Caution with Melatonin: Some SSRIs (fluvoxamine) spike melatonin levels — microdose or skip.
- Caution with L-Tryptophan / 5-HTP: Serotonin-syndrome risk — do not combine without a prescriber.
- Caution with Mucuna Pruriens (L-Dopa): Serotonergic/MAOI combinations risk serious reactions.
- Caution with SAM-e: Serotonergic — serotonin-syndrome risk; only with a prescriber.
- Caution with Methylene Blue: MAO inhibition + serotonergic drugs = serotonin-syndrome risk. Do not combine.
- Caution with Kanna (Sceletium tortuosum): SSRI-like reuptake inhibition — serotonin-syndrome risk; don't combine.
- Caution with Ashwagandha: Additive sedation and serotonergic case reports — clear it with the prescriber.
- Caution with NSAIDs: SSRIs plus NSAIDs sharply raise GI-bleeding risk — a well-documented pairing.
Interactions
Documented pairings with supplements and medicines. A medicine on this list is a conversation for whoever prescribes it.
St. John's WortCaution
Serotonin-syndrome risk — never combine.
SaffronCaution
Serotonergic — additive load; clear with prescriber.
MelatoninCaution
Some SSRIs (fluvoxamine) spike melatonin levels — microdose or skip.
L-Tryptophan / 5-HTPCaution
Serotonin-syndrome risk — do not combine without a prescriber.
Mucuna Pruriens (L-Dopa)Caution
Serotonergic/MAOI combinations risk serious reactions.
SAM-eCaution
Serotonergic — serotonin-syndrome risk; only with a prescriber.
Methylene BlueCaution
MAO inhibition + serotonergic drugs = serotonin-syndrome risk. Do not combine.
Kanna (Sceletium tortuosum)Caution
SSRI-like reuptake inhibition — serotonin-syndrome risk; don't combine.
AshwagandhaCaution
Additive sedation and serotonergic case reports — clear it with the prescriber.
NSAIDsCaution
SSRIs plus NSAIDs sharply raise GI-bleeding risk — a well-documented pairing.
The evidence in words
What it is
Selective serotonin (and serotonin-norepinephrine) reuptake inhibitors — first-line drugs for depression and anxiety.
How it works
They raise synaptic serotonin (and, for SNRIs, norepinephrine) by blocking its reuptake. That serotonergic action is the root of their most dangerous supplement interactions.
What it's used for
Depression, generalized and social anxiety, panic disorder, OCD, PTSD, and some chronic-pain and menopausal indications.
Supplement & drug interactions
SSRIs & SNRIs has 10 documented interactions mapped below and in the interactions graph. The overriding supplement rule with any SSRI/SNRI: nothing else serotonergic without the prescriber. 5-HTP, tryptophan, St John's Wort, high-dose saffron and SAM-e can push toward serotonin syndrome; NSAIDs raise GI-bleeding risk.
The rule
This is a medication reference for spotting interactions, not dosing advice. Every change to a supplement stack around a prescription belongs with the person who prescribes it.
Related reading
Entries that share this one's tags or conditions.
- MAOIsMonoamine oxidase inhibitors — older, powerful antidepressants with the strictest interaction profile in psychiatry.Evidence grade A
- ADHD StimulantsPrescription stimulants for attention-deficit/hyperactivity disorder.Evidence grade A
- AlcoholEthanol — a CNS depressant and hepatotoxin with a broad interaction footprint.Evidence grade A
- AntibioticsDrugs that kill or stop bacteria — short courses with long gut shadows.Evidence grade A
Sources
This entry lists no references of its own.
Last revised . A grade is this entry's reading of the evidence, not medical advice.