Drug & supplement interaction

American Spikenard + Esketamine

Esketamine brand name: Spravato.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between American Spikenard and Esketamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

American Spikenard and Esketamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Esketamine and American Spikenard in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Spikenard safety at a glance

American Spikenard overall Use caution Little is known about its safety from modern studies, so use cautiously and short-term.
Pregnancy Possibly Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Avoid Avoid while breastfeeding due to a lack of safety information.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esketamine and American Spikenard? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esketamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esketamine is filed under 2 classifications — tricyclic antidepressants (tcas), antidepressant drugs. American Spikenard has documented interactions with 1 drug class — the most serious being diuretic drugs (minor) — and none of Esketamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Spikenard Does Interact With Other Medications

American Spikenard has 75 minor known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Minor 75 No known interaction 2,755 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against American Spikenard

Covers the 2,830 medications we’ve checked against American Spikenard. Pick one to open its full report.

What to actually watch for

What Esketamine’s Own FDA Label Lists

This is not an interaction — none of it involves American Spikenard. These are the most notable effects listed in the ADVERSE REACTIONS section of Esketamine’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 4 of them are worth acting on rather than waiting out — marked below.

  • Thoughts of self-harm Worth acting on mentioned in 7.6% of FDA reports for Esketamine
  • Memory problems Worth acting on
  • Low mood Worth acting on mentioned in 4.9% of FDA reports for Esketamine
  • Raised blood pressure Worth acting on mentioned in 4.8% of FDA reports for Esketamine
  • Drowsiness mentioned in 15.3% of FDA reports for Esketamine
  • Anxiety or restlessness
  • Tiredness
  • Dizziness
  • Nausea mentioned in 5.4% of FDA reports for Esketamine
  • Vomiting

Showing the 10 most notable of 11 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Esketamine. Read the label on DailyMed › Where a percentage is shown, it is the share of 17,728 voluntary FDA FAERS reports for Esketamine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. American Spikenard’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no American Spikenard side to compare — that is a limit of the record, not a statement that American Spikenard has no side effects.

Special populations

American Spikenard in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers American Spikenard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

How much people look this up

Where American Spikenard and Esketamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Spikenard
Top half

#673 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Esketamine
Steady interest

#2,267 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Spikenard reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The American Spikenard and Esketamine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About American Spikenard

What is American Spikenard?

American Spikenard
  • Cough and chest congestion
  • Common cold
  • Asthma symptoms
  • Promoting sweating
  • Skin and wound support (topical)

American spikenard is a traditional North American herb used mainly as an expectorant and to ease coughs and colds, but there is no reliable human research to confirm it works. If you choose to try it, use it short-term, follow the product label, and check with a pharmacist or doctor first—especially if you are pregnant, breastfeeding, or have a health condition.

Aralia racemosa · Araliaceae · Root and rhizome · Tea, tincture, dried root, capsules, syrup

An interaction check asks whether these two react with each other — it does not ask whether American Spikenard is a good idea for someone in your situation. Here is what our American Spikenard record says about it on its own.

American Spikenard: dosing

There is no established or standardized dose for American spikenard. Traditional preparations include teas made from the dried root, tinctures, and syrups, but reliable dosing guidelines based on research do not exist.If you choose to use it, follow the directions on the product label and do not exceed the recommended amount.

From our American Spikenard monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Spikenard monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato (esketamine) nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant.

Important limitations: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior directly. Even if you feel better after an early dose, hospitalization may still be needed if your doctor determines it's necessary. Spravato is not approved for use in children or as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & American Spikenard

Browse every other medication we’ve checked against American Spikenard — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
75Minor
2,754No known interaction
75 Minor 2,754 No interaction
Minor

75 interactions

Showing 60 of 75 minor interactions — see all 75 on the American Spikenard page.

No interaction 2,754 drugs checked — show the list

We also checked American Spikenard against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,754 medications checked with no known interaction — see the full American Spikenard list.

See the full American Spikenard interactions page
See every supplement checked against Esketamine, ranked by severity
Evidence & sources

American Spikenard References

The 1 references that drive our American Spikenard monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Spikenard and Esketamine Together: Common Questions

Is it safe to take American Spikenard with Esketamine?
We do not list a known interaction between American Spikenard and Esketamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the American Spikenard and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and American Spikenard has documented interactions with 1 drug class — none of Esketamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Spikenard interact with any other medications?
Yes. American Spikenard has 75 documented drug interactions in our database — Esketamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — American Spikenard is not one of them. The Esketamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

American Spikenard monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 1 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and American Spikenard?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.