Both increase serotonin activity and combining them raises the risk of serotonin syndrome.
St. John's Wort and SAMe both enhance serotonergic activity through different mechanisms.
Do not combine. Use one or the other under medical guidance.
Known drug category interactions for these supplements. Especially relevant if you take prescription medications.
Combining St. John's Wort with SSRIs can cause serotonin syndrome, a potentially life-threatening condition.
NEVER combine St. John's Wort with SSRIs, SNRIs, or MAOIs. Wait at least 2 weeks after stopping an SSRI before starting St. John's Wort.
St. John's Wort reduces the effectiveness of hormonal birth control, potentially causing contraceptive failure.
Use a non-hormonal backup contraceptive method while taking St. John's Wort and for one month after stopping.
St. John's Wort significantly reduces warfarin blood levels, potentially causing blood clots.
Do not take St. John's Wort while on warfarin. If already taking both, do not stop St. John's Wort abruptly — consult your doctor.