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Supplements and your medication

Supplements and SNRIs (venlafaxine, duloxetine)

Reviewed June 2026

SNRIs like venlafaxine and duloxetine raise serotonin in much the same way SSRIs do (they also raise noradrenaline, hence the extra "N"). For supplements, that means the same rules apply: most are fine, two are a hard stop, and a few sit in a cautious middle. The logic is the serotonin one. Anything that also raises serotonin can stack on top and push it too high.

The two hard stops

5-HTP is a direct building block of serotonin, so taking it with an SNRI piles serotonin on serotonin and risks serotonin syndrome, a real and occasionally dangerous reaction. This is a do-not-combine, not a be-careful. St John's Wort is the second: it raises serotonin in its own right and also speeds up the clearance of many other medicines, which makes it doubly unsuitable. Both belong on the avoid list with an SNRI, exactly as they do with an SSRI.

The cautious middle

A few mood-and-stress supplements have enough serotonergic or mood activity to be worth a clinician's eye before you start: saffron, SAM-e and ashwagandha. They are not automatic exclusions like the first two, but they are worth raising with whoever prescribes your antidepressant rather than starting quietly.

What is genuinely fine

Omega-3, vitamin D and magnesium have no serotonin involvement and sit comfortably alongside an SNRI for their own reasons.

If the supplement you are weighing up is for mood or anxiety specifically, that is exactly the case to check rather than guess. The free checker assesses your exact combination and shows you which tier each pair falls into. The same serotonin rules, in more detail, are in the SSRI guide.

Free tool

Want to check your exact combination? Put your supplements and medications in together, free, and see every pair assessed.

Open the interactions checker
This is general information, not medical advice. It does not replace a conversation with your GP or pharmacist, who know your full history. If you take prescription medication, check before starting or stopping a supplement. Distil grades the evidence behind each compound and assesses each pair against published clinical literature; we do not diagnose or prescribe.