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Class landing · SSRIs

Supplements and SSRIs.

What to avoid, what to use with caution, and what is safe alongside sertraline, citalopram, fluoxetine and other SSRIs.

SSRIs (selective serotonin reuptake inhibitors) raise serotonin levels in the synapse. Some supplements do the same, by a different mechanism. Combining them risks serotonin syndrome, a documented clinical emergency.

The hard exclusion is 5-HTP: never alongside an SSRI or any other antidepressant. St John’s Wort is also off the table, both for the serotonergic stack-up and because it induces CYP3A4 and accelerates clearance of many co-prescribed drugs. Saffron, ashwagandha, and SAM-e all sit in the cautious tier and need GP review 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.
Type the supplement name. Click each match to add it.
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Pick any that apply. We adjust the findings where context changes the answer.
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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.

Read the full methodology
Your whole stack

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This page checks the pairs you enter. The personalised Distil report goes further:

  • the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
  • where your current routine may be leaving you short of your goals
  • the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

See a real sample report
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.