Can you take St. John's wort with Zoloft or other SSRIs?
Also searched as: SSRI, antidepressant, Hypericum
Short answer
This combination is generally avoided. Both raise serotonin, and together they can cause serotonin syndrome, which can be serious.
Why it happens
Sertraline and St. John's wort both increase serotonin activity in the brain. Combined, serotonin can build up too much. St. John's wort also changes how the body processes many other medicines.
What to do
- Don't start St. John's wort while taking an SSRI unless your prescriber says it's okay.
- If you already take both, don't stop either suddenly. Talk to your prescriber or pharmacist first.
Signs to watch for
- Agitation or confusion
- Fast heartbeat
- Sweating, shivering or fever
- Muscle twitching or stiffness
- Diarrhea
If symptoms are severe, call 911 or go to the nearest emergency room.
Sources
Last reviewed November 4, 2026. For education only, not medical advice. Talk to your pharmacist or prescriber before changing anything.
