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Supplements and SNRIs.

What to avoid and what needs caution alongside venlafaxine and duloxetine.

SNRIs (serotonin and noradrenaline reuptake inhibitors, venlafaxine and duloxetine) raise serotonin much as SSRIs do, so the serotonergic supplement concerns are the same. Combining them with something that also pushes serotonin up risks serotonin syndrome.

The hard exclusions are 5-HTP and St John’s Wort: never alongside an SNRI. St John’s Wort also speeds up the enzymes that clear it and can lower the drug’s level. Saffron, SAM-e, rhodiola and tryptophan all sit in the cautious tier on the same serotonergic pathway and are worth reviewing with your GP before starting.

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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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