antidepressant interaction
4 interactions related to antidepressant interaction
amitriptyline + st. john's wort
St. John's wort induces CYP3A4 and CYP2D6 enzymes that metabolize amitriptyline, reducing its plasma concentrations by up to 22%, while simultaneously adding serotonergic activity that can trigger serotonin syndrome. The combined result is paradoxical: less antidepressant effect plus higher risk of a potentially fatal serotonin reaction.
trazodone + 5-htp
Both trazodone and 5-HTP increase central serotonin activity. Trazodone blocks the serotonin transporter and acts on 5-HT2 receptors, while 5-HTP is a direct precursor to serotonin and bypasses the normal regulation of tryptophan availability. Combining them can produce additive serotonergic effects and risk of serotonin syndrome.
bupropion + st. john's wort
Bupropion lowers the seizure threshold and St. John's wort may compound that risk, and the herb's induction of CYP enzymes (particularly the role of CYP2B6 and downstream pathways) can also alter bupropion exposure. Both also influence monoamine signaling, raising the risk of additive CNS effects.
nortriptyline + st. john's wort
St. John's wort induces CYP3A4 and CYP2D6, the enzymes responsible for metabolizing nortriptyline, reducing nortriptyline blood levels and antidepressant effect. The herb also adds serotonergic activity that may increase risk of serotonin syndrome.