Can You Take St. John's Wort With Prozac?

Hello and thanks for reaching out!

While it is often difficult to determine whether or not there are serious drug interactions between prescription drugs and herbal/nutritional supplements due to the lack of published information, St. John's Wort has been extensively studied. In fact, it is one of the most well-researched herbal medications in the world.

Since there is a large amount of published information regarding St. John's Wort, we have a fairly good idea about how it works, what it can be used for, and potential drug interactions to be concerned about.

As it concerns St. John's Wort and Prozac specifically, there is a significant interaction between them and they should not be used together in most cases.

Interaction Detail

The use of St. John's Wort and Prozac may result in an increased risk of serotonin syndrome (which is characterized by symptoms such as high blood pressure, increased body temperature, muscle twitching, and mental status changes).

This can occur since both St. John's Wort and Prozac increase the amount of the neurotransmitter serotonin in the brain.

Too much serotonin can result in serotonin syndrome, which is relatively rare, but a very serious condition if it does occur.

This interaction occurs not only between St. John's Wort and Prozac, but between St. John's Wort and all SSRIs (selective serotonin reuptake inhibitors), which include:

• Zoloft (sertraline)
• Luvox (fluvoxamine)
• Lexapro (escitalopram)
• Celexa (citalopram)
• Paxil (paroxetine)

How To Manage The Interaction

As mentioned, Prozac and St. John's wort should not be used together.

It is advised to wait two weeks after stopping St. John's Wort before restarting selective serotonin reuptake inhibitor therapy.

If you plan to replace a selective serotonin reuptake inhibitor (SSRI), like Prozac, with St. John's Wort, the half-life of the specific SSRI should be taken into consideration, waiting for at least 5 half-lives for the SSRI to be metabolized out of the body.

Prozac has an extremely long half-life, which is reported to be between 1 and 4 days. In some individuals, it can be as long as a week. For this reason, it takes a long time for our body to completely metabolize it. You should wait at least 2 weeks after stopping Prozac to start St. John's Wort. It may even be recommended to wait up to a month to be safe.

Final Words

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