Health question
Can I take St. John's wort with sertraline (Zoloft)?
Checked against the sources below on October 19, 2026
The short answer
No, not without a clinician's advice. St. John's wort raises serotonin, as sertraline does, and taking them together can cause serotonin syndrome, which can be serious. St. John's wort also changes how the body handles many other medicines. Talk to your doctor or pharmacist before starting or stopping either one.
Why the combination is risky
- Sertraline is an SSRI antidepressant. St. John's wort is a herbal supplement that also affects serotonin. Combined, serotonin can build up too much.
- St. John's wort also speeds up the breakdown of many medicines, including birth control pills, blood thinners such as warfarin, and some heart and transplant medicines, which can make them work less well.
Warning signs of serotonin syndrome
- Agitation or confusion, fast heartbeat, sweating, shivering, diarrhea, muscle twitching or stiffness, and high fever.
- Severe symptoms such as high fever, seizures or an irregular heartbeat are an emergency: call 911 or your local emergency number.
What to do
- Tell your doctor and pharmacist about every supplement you take, including herbal products and teas.
- Do not stop sertraline suddenly or switch to St. John's wort on your own. Changes should be planned with a clinician.
Check your own medicines and results
MidLune checks your medicines and supplements against each other, reads your lab reports in plain words, and helps you prepare questions for your next visit.
Create your accountSources
- NCCIH (U.S. NIH): St. John's wort (opens in a new tab)
- MedlinePlus: Sertraline (opens in a new tab)
- MedlinePlus: Serotonin syndrome (opens in a new tab)
This page is general information, not medical advice. It does not replace a conversation with your doctor or pharmacist. See our medical disclaimer.