Sertraline
Common brand names:
ZoloftSertraline is a member of the selective serotonin reuptake inhibitor (SSRI) family of drugs used to treat people with depression.
Summary of Interactions with Vitamins, Herbs, & Foods
-
Negative Interactions
3-
Potential Negative Interaction
Sertraline
5-HTP
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Sertraline increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with sertraline may increase sertraline-induced side effects.
In one report, dietary supplements of L-tryptophan (available only by prescriptions from special compounding pharmacists) taken with paroxetine (a drug similar to sertraline) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms. On the other hand, the combination of 45 mg DL-tryptophan (a synthetic variation of L-tryptophan) per pound of body weight (a relatively high dose) with zimelidine, a drug with a similar action to sertraline, did not cause these side effects in another trial. Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase the effectiveness of the latter. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with sertraline or other SSRIs, unless the combination is being closely monitored by a doctor. Foods rich in L-tryptophan do not appear to interact with sertraline or other SSRIs.
5-HTPSertraline- Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1997, 264q-4r.
- Walinder J, Carlsson A, Persson R. 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psych Scand Suppl 1981;290:179-90.
-
Potential Negative Interaction
Sertraline
L-Tryptophan
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Sertraline increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with sertraline may increase sertraline-induced side effects.
In one report, dietary supplements of L-tryptophan (available only by prescriptions from special compounding pharmacists) taken with paroxetine (a drug similar to sertraline) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms. On the other hand, the combination of 45 mg DL-tryptophan (a synthetic variation of L-tryptophan) per pound of body weight (a relatively high dose) with zimelidine, a drug with a similar action to sertraline, did not cause these side effects in another trial. Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase the effectiveness of the latter. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with sertraline or other SSRIs, unless the combination is being closely monitored by a doctor. Foods rich in L-tryptophan do not appear to interact with sertraline or other SSRIs.
L-TryptophanSertraline- Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1997, 264q-4r.
- Walinder J, Carlsson A, Persson R. 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psych Scand Suppl 1981;290:179-90.
-
Potential Negative Interaction
Sertraline
St. John’s Wort
One report described a case of serotonin syndrome in a patient who took St. John’s wort and trazodone, a weak SSRI drug. The patient reportedly experienced mental confusion, muscle twitching, sweating, flushing, and ataxia. In another case, a patient experienced grogginess, lethargy, nausea, weakness, and fatigue after taking one dose of paroxetine (Paxil®, another SSRI drug) after ten days of St. John’s wort use.
St. John’s WortSertraline- Demott K. St. John's wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.
- Gordon JB. SSRIs and St. John's wort: possible toxicity? Am Fam Physician 1998;57:950.
-
-
Supportive Interactions
3-
Replenish Depleted Nutrients
Sertraline
Sodium
SSRI drugs, including sertraline, have been reported to cause sodium depletion. The risk for SSRI-induced sodium depletion appears to be increased during the first few weeks of treatment in women, the elderly, and patients also using diuretics. Doctors prescribing SSRI drugs, including sertraline, should monitor their patients for signs of sodium depletion.
SodiumSertraline- Spigset O, Hedenmalm K, Mortimer O. Hyponatremia as a side effect of serotonin uptake inhibitors. Lakartidningen 1998;95:3537-9 [Swedish].
- Strachan J, Shepherd J. Hyponatraemia associated with the use of selective serotonin re-uptake inhibitors. Aust N Z J Psychiatry 1998;32:295-8.
- Bouman WP, Pinner G, Johnson H. Incidence of selective serotonin reuptake inhibitor (SSRI) induced hyponatraemia due to the syndrome of antidiuretic hormone (SIADH) secretion in the elderly. Int J Geriatr Psychiatry 1998;13:12-5.
-
Support Medicine
Sertraline
Chromium
There have been five case reports of chromium supplementation (200–400 mcg per day) significantly improving mood in people with a type of depression called dysthymic disorder who were also taking sertraline. These case reports, while clearly limited and preliminary in scope, warrant a controlled trial to better understand the benefits, if any, of chromium supplementation in people taking this drug.
ChromiumSertraline- McLeod MN, Gaynes BN, Golden RN. Chromium potentiation of antidepressant pharmacotherapy for dysthymic disorder in 5 patients. J Clin Psychiatry 1999;60:237-40.
-
Reduce Side Effects
Sertraline
Ginkgo
In three men and two women treated with fluoxetine or sertraline (SSRI drugs closely related to paroxetine) for depression who experienced sexual dysfunction, addition of Ginkgo biloba extract (GBE) in the amount of 240 mg per day effectively reversed the sexual dysfunction. This makes sense because ginkgo has been reported to help men with some forms of erectile dysfunction.
GinkgoSertraline- Cohen AJ. Long term safety and efficacy of Ginkgo biloba extract in the treatment of anti-depressant-induced sexual dysfunction. Psychiatry On-Line http://www.priory.com/ginkgo.html.
- Sohn M, Sikora R. Ginkgo biloba extract in the therapy of erectile dysfunction. J Sex Educ Ther 1991;17:53-61.
-
-
Explanation Required
1-
Needs Explanation
Sertraline
Grapefruit
In a study of healthy volunteers, ingestion of grapefruit juice along with sertraline increased blood levels of the drug. Eating grapefruit or drinking grapefruit juice may therefore increase both the effectiveness and the adverse effects of sertraline. People taking sertraline should not consume grapefruit without medical supervision.GrapefruitSertraline- Ueda N, Yoshimura R, Umene-Nakano W, et al. Grapefruit juice alters plasma sertraline levels after single ingestion of sertraline in healthy volunteers. World J Biol Psychiatry 2009;10:832-835.
-