Syrian Rue + Mirtazapine
Mirtazapine brand name: Remeron.
Mirtazapine falls into 3 drug categories that Syrian Rue can interact with; the most serious is rated moderate. Theoretically, Syrian rue might increase the risk of serotonergic adverse effects, including serotonin syndrome, when taken with serotonergic drugs.
Read the full interaction reportSyrian Rue and Mirtazapine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Syrian Rue interacts with whole categories of medication. Mirtazapine falls into 3 of those categories, so it can interact with Syrian Rue in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEROTONERGIC DRUGS
1 of 3Why this applies to Mirtazapine
Mirtazapine falls under SEROTONERGIC DRUGS — the group Syrian Rue interacts with.
Syrian rue contains harmaline and harmine, which have demonstrated strong, reversible inhibition of monoamine oxidase (MAO) A and weak inhibition of MAO B in animal and in vitro research. This may increase the risk for adverse effects with serotonergic drugs.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the concern with pairing Syrian Rue and mirtazapine. Mirtazapine raises serotonin activity in your brain to lift mood. Syrian Rue's seeds contain harmine and harmaline, compounds that act like MAO inhibitors, meaning they slow the enzyme that normally clears extra serotonin. Stack those two together and serotonin can climb higher than intended.
When serotonin gets too high, you can run into what's called serotonin syndrome: agitation, a racing heart, sweating, shivering, muscle twitching, or confusion. It's uncommon but worth taking seriously. Honestly, this is based mostly on lab and animal research, not solid human studies, but the mechanism is real enough that I'd steer clear of combining them. Please check with your pharmacist or doctor before adding Syrian Rue.
- Kawanishi, K., Hashimoto, Y., Fujiwara, M., Kataoka, Y., and Ueki, S. Pharmacological characteristics of abnormal behavior induced by harmine with special reference to tremor in mice. J Pharmacobiodyn 1981;4(7):520-527. PubMed
- Herraiz, T., Gonzalez, D., Ancin-Azpilicueta, C., Aran, V. J., and Guillen, H. beta-Carboline alkaloids in Peganum harmala and inhibition of human monoamine oxidase (MAO). Food Chem Toxicol 2010;48(3):839-845. PubMed
- Fuller, R. W., Wong, C. J., and Hemrick-Luecke, S. K. MD 240928 and harmaline: opposite selectivity in antagonism of the inactivation of types A and B monoamine oxidase by pargyline in mice. Life Sci 1986;38(5):409-412. PubMed
- Abdel-Fattah, A. F., Matsumoto, K., Murakami, Y., Adel-Khalek, Gammaz H., Mohamed, M. F., and Watanabe, H. Central serotonin level-dependent changes in body temperature following administration of tryptophan to pargyline- and harmaline-pretreated rats. Ge PubMed
- Bergstrom, M., Westerberg, G., and Langstrom, B. 11C-harmine as a tracer for monoamine oxidase A (MAO-A): in vitro and in vivo studies. Nucl Med Biol 1997;24(4):287-293. PubMed
- Gerardy, J. Effect of moclobemide on rat brain monoamine oxidase A and B: comparison with harmaline and clorgyline. Prog Neuropsychopharmacol Biol Psychiatry 1994;18(4):793-802.
- Sacher, J., Houle, S., Parkes, J., Rusjan, P., Sagrati, S., Wilson, A. A., and Meyer, J. H. Monoamine oxidase A inhibitor occupancy during treatment of major depressive episodes with moclobemide or St. John's wort: an [11C]-harmine PET study. J Psychiatry
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 3Mirtazapine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Syrian rue contains beta-carboline alkaloids, including harmine, harmaline, harmalol, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids can inhibit CYP2D6 enzymes.
Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..
Here's the situation with these two together. Mirtazapine (Remeron) is partly broken down by a liver enzyme called CYP2D6. Lab studies suggest the harmala alkaloids in Syrian Rue can block that enzyme. If that happens in your body, your mirtazapine may not clear as quickly and could build up, which can mean stronger effects like heavy drowsiness, dizziness, increased appetite, and weight gain.
There's a bigger worry too. Syrian Rue acts like an MAO inhibitor, and combining MAOIs with an antidepressant like mirtazapine can raise the risk of too much serotonin (agitation, fast heartbeat, sweating, confusion). The enzyme part is theoretical and based on test-tube work, but I'd treat this combo cautiously. Please check with your pharmacist or doctor before mixing them.
- Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Mirtazapine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Syrian rue contains beta-carboline alkaloids, including harmine, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids competitively inhibit CYP3A4 enzymes.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the situation with these two. Your body uses an enzyme called CYP3A4 to help clear mirtazapine. Lab studies hint that the harmala alkaloids in Syrian Rue can slow that enzyme down. If that happened in real life, mirtazapine could build up a bit more than usual, which might mean stronger effects like extra drowsiness, dizziness, increased appetite, or feeling foggy. Mirtazapine works as it is, so it doesn't get "activated" by this enzyme, meaning more drug means more effect, not less.
I want to be honest though: this is theoretical, based only on test-tube data, not real patients. The bigger worry is that Syrian Rue acts like an MAO inhibitor, and combining that with an antidepressant can be genuinely dangerous. Please talk with your doctor or pharmacist before mixing these.
- Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Syrian Rue Also Interacts With Other Medications
Syrian Rue has 1,121 moderate known drug interactions in our database — the Mirtazapine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Syrian Rue
We haven’t checked that one against Syrian Rue yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Syrian Rue. Pick one to open its full report.
Questions About Syrian Rue or Mirtazapine
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Syrian Rue or Mirtazapine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- Does DIM (Diindolylmethane) Interact With Any Drugs? ›
- Does Zoloft (Sertraline) Cause Neck And Jaw Tightness? ›
- How Long Does Amitriptyline Take To Work For Headaches? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Mirtazapine
This page covers Syrian Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mirtazapine page lists 212 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 1,3-dmaa (moderate).
By severity: 4 major · 162 moderate · 46 minor.
From our pharmacist’s overview on the Mirtazapine page
“Depression and poor sleep tend to travel together, which is why people on mirtazapine (Remeron) so often eye herbal mood and sleep remedies, and that overlap is exactly where this list demands real care. Four of the 212 ingredients on file carry a major rating.”
Reviewed by 2 · Jul 18, 2026
Where Syrian Rue and Mirtazapine 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.
#861 of 1,452 supplements looked up here in the last 7 days
#276 of 2,830 medications looked up here in the last 7 days
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.
About Syrian Rue
What is Syrian Rue?
- Traditional remedy for digestive complaints
- Used as a sedative or for mood
- Antimicrobial and antiparasitic folk use
- Used as a dye and incense
- Recreational psychoactive use
Syrian Rue (Peganum harmala) is a traditional plant whose seeds contain potent compounds called harmala alkaloids, including MAO-inhibiting harmine and harmaline. There is little reliable human evidence that it safely treats any condition, and it carries real risks of toxicity, so it is not recommended for self-treatment. Talk to a pharmacist or doctor before considering it.
About Mirtazapine
What Is Mirtazapine Used For?
Brand name: Remeron
Mirtazapine is used to treat major depressive disorder (MDD), commonly called clinical depression. The mirtazapine tablet and orally disintegrating tablet labels, including Remeron and RemeronSolTab, state use in adults.
In studies, it worked in six-week trials, and one trial showed the benefit lasted for up to 40 weeks in people who had already responded. Doctors should periodically re-check whether longer-term use is still helping.
Other Drugs & Syrian Rue
Browse every other medication we’ve checked against Syrian Rue — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,121 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Diphenhydramine ›
- Hydrocortisone ›
- Methylphenidate ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Glycopyrrolate ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Phenylephrine ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Dimenhydrinate ›
- Everolimus ›
Showing 60 of 1,121 moderate interactions — see all 1,121 on the Syrian Rue page.
No interaction 1,708 drugs checked — show the list
We also checked Syrian Rue against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Aspirin ›
- Isotretinoin ›
- Tirzepatide ›
- Ibuprofen ›
- Docusate ›
- Hydroxyurea ›
- Metformin ›
- Valacyclovir ›
- Semaglutide ›
- Levothyroxine, Liothyronine ›
- Lisinopril ›
- Bupropion ›
- Azithromycin ›
- Bendamustine ›
- Pregabalin ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Naproxen ›
- Candesartan Cilexetil ›
- Acetylsalicylic Acid ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Ezetimibe ›
- Cyclopentolate ›
- Cephalexin ›
- Atenolol, Chlorthalidone ›
- Avatrombopag Maleate ›
- Thyroid Hormone ›
- Levetiracetam ›
- Mannitol ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Sacubitril, Valsartan ›
- Roxithromycin ›
- Canagliflozin, Metformin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Spironolactone ›
- Valsartan ›
- Enalapril Maleate ›
- Aspirin, Butalbital ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Bupivacaine, Meloxicam ›
- Alginic Acid, Aluminum Hydroxide ›
- Mitomycin ›
- Ephedrine, Phenobarbital, Theophylline ›
- Atenolol ›
- Amobarbital, Ephedrine Sulfate ›
- Flutemetamol F-18 ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Abrocitinib ›
- Efgartigimod Alfa-fcab ›
- Levothyroxine Sodium ›
- Irbesartan, Hydrochlorothiazide ›
- Charcoal (otc Drug) ›
- Magnesium Hydroxide (otc Drug) ›
- Aminophylline, Amobarbital, Ephedrine ›
- Peginterferon Alfa-2a, Ribavirin ›
Showing the 60 most looked-up of 1,708 medications checked with no known interaction — see the full Syrian Rue list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Mirtazapine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Mirtazapine as a medicine that can lower these. This is not an interaction with Syrian Rue — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Mirtazapine nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Syrian Rue and Mirtazapine Together: Common Questions
Can you take Syrian Rue with Mirtazapine?
Why are there 3 interactions listed for Syrian Rue and Mirtazapine?
How serious is the Syrian Rue and Mirtazapine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Mirtazapine and Syrian Rue?
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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.