Drug Information

Escitalopram is used to treat mental depression and is in a class of drugs known as selective serotonin reuptake inhibitor (SSRI) antidepressants.

Common brand names:

Lexapro

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • St. John’s Wort

    There have been no published reports about negative consequences of combining St. John’s wort (Hypericum perforatum)  (Hypericum perforatum)  (Hypericum perforatum) and fluoxetine. One case has been reported of an interaction between St. John’s wort and a weak serotonin reuptake inhibitor drug known as trazodone that is vaguely similar to fluoxetine.1 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.2 Nevertheless, some doctors are concerned about the possibility of an interaction between St. John’s wort and fluoxetine causing side effects (e.g., mental confusion, muscle twitching, sweating, flushing) known collectively as serotonin syndrome.3 , 4 Until more is known about interactions and adverse actions, people taking any SSRI drugs, including fluoxetine, should avoid St. John’s wort, unless they are being closely monitored by a doctor.

  • 5-HTP

    Escitalopram 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 escitalopram may increase escitalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as escitalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.5

    Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with escitalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with escitalopram or other SSRIs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • L-Tryptophan

    Escitalopram 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 escitalopram may increase escitalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as escitalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.6

    Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with escitalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with escitalopram or other SSRIs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Demott K. St. John's wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.

2. Gordon JB. SSRIs and St. John's wort: possible toxicity? Am Fam Physician 1998;57:950.

3. Bekman SE, Sommi RW, Switzer J. Consumer sue of St. John's wort: A survey on effectiveness, safety, and tolerability. Pharmacotherapy 2000;20:568-74.

4. Lantz MS, Buchalter E, Giambanco V. St. John's wort and antidepressant drug interaction in the elderly. J Geriatr Psychiatry Neurol 1999;12:7-10.

5. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.

6. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.