NutriStack
Escitalopram and Fish Oil, a caution.
Escitalopram impairs platelet aggregation by depleting platelet serotonin stores, and high-dose fish oil adds modest antiplatelet activity by reducing thromboxane A2 synthesis. Combined use raises bleeding risk, particularly with NSAIDs or anticoagulants.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Escitalopram and Fish Oil
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Escitalopram impairs platelet aggregation by depleting platelet serotonin stores, and high-dose fish oil adds modest antiplatelet activity by reducing thromboxane A2 synthesis. Combined use raises bleeding risk, particularly with NSAIDs or anticoagulants.
Mechanism. Escitalopram blocks the platelet serotonin transporter, depleting intra-platelet 5-HT needed for normal aggregation. EPA/DHA shift the prostaglandin/thromboxane balance toward less aggregatory species.
Recommendation. Keep fish oil dose moderate (≤1g/day) with escitalopram. Avoid high-dose regimens (>3g/day) unless your prescriber agrees, and stop fish oil 7 days before any planned surgery.
Sources (2)
- Andrade C, Sandarsh S, Chethan KB, Nagesh KS. Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. J Clin Psychiatry. 2010;71(12):1565-75. PMID 21190637
- Laporte S, Chapelle C, Caillet P, et al. Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta-analysis of observational studies. Pharmacol Res. 2017;118:19-32. PMID 27521835
Stack Score
How this pair moves the number.
Effect on the composite score
If both Escitalopram and Fish Oil are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
Check your full routine
One pair was the worked example. NutriStack runs every pair in your stack at once.
Drop in your supplements and prescriptions and the public database surfaces every interaction, synergy, timing rule, and contraindication, every one linked to its primary source.