Is Zoloft Safe To Take With Boswellia And Turmeric?

Quick Answer

Preliminary investigations indicate that Boswellia serrata and turmeric may inhibit the metabolizing enzyme CYP3A4 in the liver. CYP3A4 is responsible for metabolizing Zoloft, and if inhibited, drug concentrations may increase, raising the possibility of adverse effects.

However, these findings are solely based on laboratory and animal studies, and there is little evidence of such inhibition occurring in humans to a clinically significant degree. Moreover, Zoloft is metabolized by several other enzymes, and the minor inhibition of one enzyme is unlikely to significantly impact its overall metabolism.

Detailed Answer

Zoloft, also known as sertraline, is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mental health disorders.

The liver primarily metabolizes Zoloft through various enzymes, including CYP3A4 and CYP2D6. Studies show that CYP3A4 is a lesser component of the overall metabolism of the drug (i.e., other enzymes, like CYP2D6 are responsible for the majority of the metabolism).

Both turmeric and Boswellia serrata have been shown in laboratory studies to mildly inhibit the CYP3A4 enzyme. However, no human studies have confirmed this effect. This is the information we have detailed on our individual drug-herbal interaction pages:

• Zoloft with Boswellia
• Zoloft with turmeric

It's important to note that there are numerous compounds within turmeric and Boswellia serrata that may affect enzyme activity, and it's unclear which compounds are responsible for the observed inhibition of CYP3A4 in laboratory studies. So, different dietary supplements with different sources, forms, or concentrations of these natural ingredients could have differing effects.

Regarding Boswellia serrata, studies have shown that supplements with high boswellic acid content are unlikely to inhibit CYP3A4 to a clinically significant degree. Instead, it's other compounds within frankincense that may cause enzyme inhibition (boswellic acids are extracted from frankincense resin, and it's the other compounds in frankincense that are thought to inhibit 3A4 according to at least one study).

In regard to turmeric, like Boswellia, it has generally only been seen to inhibit CYP3A4 in lab studies although there was one case report where extreme consumption of turmeric (15 spoonfuls per day) was thought to be a contributing factor in the concentration of a drug called tacrolimus getting too high, causing adverse effects.

Significant inhibition of CYP3A4, however, is not thought to be an issue with the usual dosing of turmeric.

Another factor that lessens the risk of a major interaction between Zoloft, Boswellia, and turmeric is the fact that since Zoloft is metabolized by multiple enzymes, the mild alteration of one enzyme likely won't cause significant problems.

Having said all of the above, it's essential to be aware of potential side effects of Zoloft, which could theoretically be increased when combined with Boswellia and turmeric, such as the increased risk of bleeding, nausea, headache, and the rare, but serious, serotonin syndrome.

It's important to inform your healthcare provider of all medications and supplements you're taking, including Boswellia serrata and turmeric, so you can be appropriately monitored.

Final Words

Thanks for your question and please be sure to reach back out if you have anything else you want answered!