antidepressant interaction
4 interactions related to antidepressant interaction
amitriptyline + st. john's wort
St. John's wort induces the cytochrome P450 enzymes (and the P-glycoprotein transporter) that clear amitriptyline, measurably lowering amitriptyline blood levels and reducing its antidepressant and pain-relieving effect. Because both also raise serotonin signaling, combining them adds a theoretical risk of serotonin syndrome. The net effect can be a weaker antidepressant plus an added safety concern.
trazodone + 5-htp
Both trazodone and 5-HTP raise serotonin activity, but through different routes. Trazodone is a serotonin antagonist and reuptake inhibitor that keeps more serotonin in the synapse, while 5-HTP is a direct precursor that increases how much serotonin the body makes. Stacking the two adds up, and major drug-interaction databases flag the pairing as a serious interaction because of the risk of serotonin syndrome.
bupropion + st. john's wort
St. John's wort induces drug-metabolizing enzymes that can lower bupropion blood levels and weaken its effect. A human case report also links the pair to a prolonged movement (dystonic) reaction from overlapping effects on brain chemicals. The often-cited additive seizure risk rests mainly on animal extract studies and is not well supported in people.
nortriptyline + st. john's wort
St. John's wort induces the liver enzymes (chiefly CYP3A4, via the pregnane X receptor) that help clear nortriptyline, which can lower nortriptyline blood levels and weaken its antidepressant effect. The herb also adds serotonergic activity, which gives an additive, theoretical increase in the risk of serotonin syndrome.