Amitriptyline and St Johns Wort

Supplement–drug interaction evidence from the TruthStack database.

SeverityCRITICAL
Evidence TierModerate
Interaction TypeSEROTONERGIC RISK
MechanismPHARMACODYNAMIC
Last Reviewed2026-02-15

Summary

St. John's Wort with tricyclic antidepressants increases serotonin syndrome risk AND reduces TCA levels via CYP3A4 induction. May cause both toxicity and treatment failure. Combination is flagged in literature. Discuss with your prescriber or pharmacist.

API Reference

GET https://api.truthstack.co/v1/check?c1=amitriptyline&c2=st_johns_wort

Open, unauthenticated. Returns JSON. Developer documentation

Related Interactions

Methylene Blue + St. John'S Wort Clozapine + St Johns Wort Ethinyl Estradiol + St Johns Wort Phenytoin + St Johns Wort St Johns Wort + Theophylline Citalopram + St Johns Wort Escitalopram + St Johns Wort Fluoxetine + St Johns Wort
What this page is and is not. TruthStack is an informational reference database that describes published pharmacological findings. It does not provide medical advice, diagnosis, or treatment recommendations. The information on this page reflects flags in our database and should not replace consultation with a qualified healthcare provider. Always discuss supplement-drug combinations with your prescriber or pharmacist.