From the Guidelines
I strongly advise against combining thesis supplements with escitalopram due to the potential risk of serotonin syndrome, a life-threatening condition. When considering the interaction between thesis supplements and escitalopram, it is crucial to prioritize caution to avoid adverse effects on morbidity, mortality, and quality of life.
Key Considerations
- The use of certain supplements, such as St. John's Wort, L-tryptophan, and other serotonergic agents, is contraindicated with SSRIs like escitalopram due to the risk of serotonin syndrome 1.
- Escitalopram, as an SSRI, has a relatively low propensity for drug interactions compared to other SSRIs, but caution is still necessary when combining it with any supplement that may affect serotonin levels or interact with the CYP450 enzyme system 1.
- The potential for drug-drug interactions varies among SSRIs, with fluvoxamine having a greater potential for interactions due to its effect on multiple CYP enzymes, whereas escitalopram may have the least effect on CYP450 isoenzymes 1.
Recommendations
- Avoid combining escitalopram with any supplement that may increase serotonin levels or interact with the CYP450 system, as this can lead to serious adverse effects, including serotonin syndrome 1.
- If a patient is already taking escitalopram and wishes to start a supplement, they should consult their healthcare provider to discuss the potential risks and benefits and to monitor for any adverse effects 1.
- In cases where a patient is taking both escitalopram and a supplement, and discontinuation of either is considered, it is essential to taper the medications gradually under medical supervision to avoid withdrawal symptoms or rebound effects 1.
From the FDA Drug Label
What should I tell my healthcare provider before taking Escitalopram tablets? Ask if you are not sure Before starting Escitalopram tablets, tell your healthcare provider if you: • Are taking certain drugs such as: • Triptans used to treat migraine headache • Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, amphetamines, or antipsychotics • Tramadol • Over-the-counter supplements such as tryptophan or St John’s Wort
The FDA drug label does not specifically mention Thesis supplement and its interaction with Escitalopram. However, it does mention to tell your healthcare provider about all the medicines that you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
- It is recommended to consult with your healthcare provider before taking any supplements, including Thesis supplement, while on Escitalopram therapy.
- Your healthcare provider can help you assess the potential risks and benefits of taking Thesis supplement with Escitalopram 2.
From the Research
Thesis Supplement and Escitalopram Interactions
- There is no direct evidence of interactions between thesis supplements and escitalopram in the provided studies.
- However, studies have shown that escitalopram has a low potential for drug interactions due to its low protein binding and metabolism by three CYP isozymes 3, 4, 5.
- One study found that concomitant administration of rasagiline and escitalopram was generally well tolerated, with no signs of central nervous system hyperexcitation or changes in vital signs 6.
- Another study reported that escitalopram was more effective than placebo and at least as effective as other comparator drugs, including SSRIs and SNRIs, in adult patients with major depressive disorder 4.
- The use of herbal supplements, such as St. John's Wort, with prescription antidepressants can increase the risk of central serotonergic syndrome, particularly in elderly patients 7.
- It is essential to note that the provided studies do not specifically address the interaction between thesis supplements and escitalopram, and more research is needed to fully understand potential interactions.