Medication · antidepressant other

Supplements and Duloxetine hydrochloride.

Every documented pair, every citation. Below: 3 documented pairs grouped by mechanism.

Duloxetine hydrochloride, sold under the brand names Cymbalta, Yentreve, is an antidepressant: depending on the agent, it acts on serotonin, noradrenaline, or both.

Duloxetine hydrochloride sits in the BNF "other antidepressants" group. The group includes the SNRIs (venlafaxine, duloxetine), the atypicals (mirtazapine, agomelatine, vortioxetine), and the older tetracyclics. The clinical class matters more than the BNF group, because the supplement profile differs sharply across it. SNRIs share the SSRI serotonergic concerns. Mirtazapine sits closer to the sedating, appetite-stimulating profile. Agomelatine is heavily liver-metabolised with mandatory LFT monitoring. Where these antidepressants share a supplement surface, it is St John's Wort (hard exclude across the class), 5-HTP (hard exclude on serotonergic grounds), and any supplement with significant sedating or activating effect depending on the agent. Discontinuation profiles differ too. Venlafaxine has the heaviest withdrawal syndrome of common antidepressants. Agomelatine probably the lightest.

Below are the 3 documented pairs we have explicitly assessed against Duloxetine hydrochloride in the Distil database: 2 red and 1 amber. The pairs cluster around 1 mechanism: Additive serotonergic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

Additive serotonergic activity

Red 5-HTP

5-HTP raises serotonin levels. Combined with an SNRI like duloxetine, it can cause serotonin syndrome. Do not combine.

BNF: Duloxetine

Red St John's Wort

St John's Wort and duloxetine both raise serotonin levels. Combined, they can cause serotonin syndrome. Do not combine.

BNF: Duloxetine

Amber Saffron Extract

Saffron has its own antidepressant effect that may stack with duloxetine's serotonergic component. Most people tolerate the combination but discuss it with your GP, especially if your dose has recently changed.

PMID 15852492 · BNF: Duloxetine

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.