Can I take Ashwagandha and Sertraline together?

Taking ashwagandha and sertraline together may increase the risk of side effects such as drowsiness and dizziness, and could potentially raise sertraline levels or increase the risk of serotonin syndrome.

Why this happens

Both substances can have a calming effect on the central nervous system, which can lead to excessive sedation when combined.

Ashwagandha may also slightly increase serotonin levels, adding to the effects of sertraline and slow down the liver enzymes (specifically CYP450 enzymes) that break down sertraline, causing the drug to stay in your system longer.

• You should consult your doctor or pharmacist before combining these two.

• If you decide to take them together, start with a low dose of ashwagandha and monitor yourself closely for excessive sleepiness or mood changes.

• Seek medical help immediately if you experience high fever, agitation, or muscle stiffness.

Depression and anxiety disorders

You may experience an increase in suicidal thoughts or the urge to self-harm when first starting sertraline or changing the dose. This is more common in young adults under 25. Contact your doctor or go to hospital immediately if you notice any changes in your mood or behaviour.

Serotonin Syndrome

Both substances can increase serotonin levels. Taking them together significantly raises the risk of serotonin syndrome, a potentially life-threatening condition.

Seek immediate medical help if you experience agitation, rapid heartbeat, or muscle twitching.

Hyperthyroidism (overactive thyroid)

Ashwagandha can increase thyroid hormone levels. It must be avoided if you have an overactive thyroid or are taking thyroid medication, as it can worsen the condition or interfere with your treatment.

Autoimmune Diseases

Ashwagandha can stimulate the immune system, which may cause autoimmune diseases such as lupus, rheumatoid arthritis, and MS to become more active. It should be avoided if you have any of these conditions.

Bleeding disorders

Sertraline can increase your risk of bleeding, particularly in the stomach or skin. Use with caution if you take blood-thinning medications (like warfarin) or anti-inflammatory painkillers (like ibuprofen or aspirin).

Alcohol

You should avoid drinking alcohol while taking sertraline. Alcohol can increase the sedative effects of the medication, making you feel more drowsy, dizzy, or uncoordinated. It can also worsen the symptoms of depression or anxiety that the medicine is treating.

It is best to avoid or strictly limit alcohol when taking ashwagandha. Ashwagandha has sedative properties, and combining it with alcohol can cause excessive drowsiness, impaired coordination, and slowed breathing.

Grapefruit juice

Grapefruit juice can increase the levels of sertraline in your blood by slowing down how your body breaks it down. This may increase the risk of side effects.

While the effect is less severe than with some other antidepressants, it is best to avoid large amounts of grapefruit juice.

Caffeine

Sertraline can sometimes cause jitteriness or tremors. High intake of caffeine (found in coffee, tea, and energy drinks) can worsen these side effects and may increase feelings of anxiety.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.