Drug & supplement interaction

Picamilon + Esketamine

Esketamine brand name: Spravato.

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

We found no known interaction between Picamilon 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Picamilon 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 Picamilon 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.

Picamilon safety at a glance

Picamilon overall Use caution Human safety data are limited and its legal status as a supplement is questionable in some countries.
Pregnancy Avoid No reliable safety data exist, so it should be avoided during pregnancy.
Breastfeeding Avoid No safety information is available, so avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esketamine and Picamilon? 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. Picamilon has documented interactions with 1 drug class — the most serious being niacin (moderate) — 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

Picamilon Does Interact With Other Medications

Picamilon has 3 moderate known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 3 No known interaction 2,827 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against Picamilon

Covers the 2,830 medications we’ve checked against Picamilon. 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 Picamilon. 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. Picamilon’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Picamilon side to compare — that is a limit of the record, not a statement that Picamilon has no side effects.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Picamilon 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

One more smart check

Taking Picamilon as Part of a Dietary Supplement Product? Check It for Interactions

We hold 135 real supplement products containing Picamilon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Picamilon. Even though Picamilon itself has no known interaction with Esketamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Picamilon 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 Picamilon
Top half

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

29 days ago today
Medication Esketamine
Steady interest

#2,265 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 Picamilon reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Picamilon and Esketamine records this page draws on were last updated June 22, 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 Picamilon

What is Picamilon?

  • Anxiety and stress
  • Mental focus and cognition
  • Low mood
  • Migraine or headache
  • Fatigue and energy

Picamilon is a synthetic compound made by joining niacin (vitamin B3) and GABA, originally developed in the former Soviet Union as a prescription drug. It is sold in some countries as a supplement for anxiety, focus, and mood, but high-quality human evidence is very limited, and U.S. regulators have stated it does not qualify as a legal dietary supplement ingredient. Talk to a pharmacist or doctor before using it.

Synthetic compound (not from a plant) · Capsules, tablets, powder

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

Picamilon: dosing

There is no officially established or standardized dose of picamilon for supplement use, and quality control of products is uncertain.If a product is available to you, follow the directions on the label and do not exceed them.

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

Read the full Picamilon 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 & Picamilon

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

0Major
3Moderate
0Minor
2,826No known interaction
3 Moderate 2,826 No interaction
Moderate

3 interactions

No interaction 2,826 drugs checked — show the list

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

Showing the 60 most looked-up of 2,826 medications checked with no known interaction — see the full Picamilon list.

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

Picamilon References

The 3 references that drive our Picamilon 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. Avula B, Chittiboyina AG, Sagi S, et al. Identification and quantification of vinpocetine and picamilon in dietary supplements sold in the United States. Drug Test Anal. 2016;8(3-4):334-43. PubMed
  2. Vishnevskii EL, Guseva NB. Validation of the treatment of the neurogenic bladder in children with myelodysplasia using pikamilon [abstract only]. Urol Nefrol (Mosk) 1998;(2):27-30.
  3. Kolomoitseva EM, Ermakova VN, Abdulkadyrova MZh. Results of pikamilon use in the treatment of patients with open-angle glaucoma [abstract only]. Vestn Oftalmol 1994;110(4):4-7.

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 Picamilon and Esketamine Together: Common Questions

Is it safe to take Picamilon with Esketamine?
We do not list a known interaction between Picamilon 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 Picamilon and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and Picamilon 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 Picamilon interact with any other medications?
Yes. Picamilon has 3 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 — Picamilon 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

Picamilon 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 3 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Picamilon?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.