NSTK · 01.2026Independent supplement reference
NutriStack
Edition 1.0Updated August 1, 2026

Supplement × Prescription·Evidence index

Sertraline and St. John's Wort: what the published research says

PubMed indexes 8 records that name Sertraline and St. John's Wort together, either in the title or in an interaction, co-administration, or pharmacokinetic context. Each one is listed below with its study design and, where the abstract states one, the authors’ own conclusion, quoted and linked. This page reports that literature. It does not tell you whether to combine them.

Read this first

An evidence index, not guidance.

Every statement below is attributed to a named, dated, linked source.

This page lists published research relevant to Sertraline and St. John's Wort. It deliberately does not state whether the combination is safe, whether it interacts, in which direction, at what dose, or how far apart to take them.

The research

8 studies naming Sertraline and St. John's Wort.

Strongest relevance first: papers naming both substances in the title, then human trials and systematic reviews.

The impact of missing data on clinical trials: a re-analysis of a placebo controlled trial of Hypericum perforatum (St Johns wort) and sertraline in major depressive disorder.

Psychopharmacology · 2014 · PMID 24232445

Randomized Controlled TrialResearch Support, N.I.H., Extramural

“There is no difference between hypericum and placebo, regardless of the assumption about the missing data process. There is a significant difference between sertraline and placebo with some statistical-methods used. It is important to conduct an analysis that takes account of missing data using valid statistically principled methods. The assumptions about the missing data process could influence the results.”

Grobler et al. · Authors' conclusion

Names both Sertraline and St. John's Wort in its title.

St John's wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT.

Pharmacopsychiatry · 2012 · PMID 22592504

Randomized Controlled TrialResearch Support, N.I.H., Extramural

“Comparisons between all treatments were however non-significant (p=0.61). This effect was mirrored on the other outcomes: the BDI, CGI-severity, CGI-improvement, and on intention-to-treat analyses.While the continuation data revealed an equivocal outcome between treatments at week 26, both SJW and sertraline were still therapeutically effective, with a pronounced "placebo-effect" impeding a significant result at week 26.”

Sarris et al. · From the abstract

Names both Sertraline and St. John's Wort in its title.

St John's wort or sertraline? Randomized controlled trial in primary care.

Canadian family physician Medecin de famille canadien · 2002 · PMID 12053635

Clinical TrialComparative StudyMulticenter StudyRandomized Controlled Trial

“The more benign side effects of SJW make it a good first choice for this patient population.”

van Gurp et al. · Authors' conclusion

Names both Sertraline and St. John's Wort in its title.

Effects of standardized extracts of St. John's wort on the single-unit activity of serotonergic dorsal Raphe neurons in awake cats: comparisons with fluoxetine and sertraline.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2001 · PMID 11750179

Comparative StudyAnimal study

“Overall, these findings indicate that the mode of action of St. John's wort is different from that of conventional antidepressant drugs, which elevate brain serotonin and evoke negative feedback control of serotonergic neurons.”

Fornal et al. · From the abstract

Names both Sertraline and St. John's Wort in its title.

Mania in a patient receiving testosterone replacement postorchidectomy taking St John's wort and sertraline.

Journal of psychopharmacology (Oxford, England) · 2000 · PMID 10757260

Case ReportsHuman subjects

“He subsequently developed a manic episode. We discuss postulated modes of action of St John's wort and the possible aetiological importance of testosterone replacement and abnormal gonadotrophin levels in this case.”

Barbenel et al. · From the abstract

Names both Sertraline and St. John's Wort in its title.

Antidepressants for smoking cessation.

The Cochrane database of systematic reviews · 2014 · PMID 24402784

Meta-AnalysisResearch Support, N.I.H., ExtramuralSystematic ReviewHuman subjects

“The antidepressants bupropion and nortriptyline aid long-term smoking cessation. Adverse events with either medication appear to rarely be serious or lead to stopping medication. Evidence suggests that the mode of action of bupropion and nortriptyline is independent of their antidepressant effect and that they are of similar efficacy to nicotine replacement.”

Hughes et al. · Authors' conclusion

Names Sertraline and St. John's Wort together in an interaction, co-administration, or pharmacokinetic context.

Interactions between herbal medicines and prescribed drugs: an updated systematic review.

Drugs · 2009 · PMID 19719333

Systematic ReviewHuman subjects

“Numerous interactions between herbal medicines and conventional drugs have been documented. While the significance of many interactions is uncertain, several interactions, particularly those with St John's wort, may have serious clinical consequences.”

Izzo et al. · From the abstract

Names Sertraline and St. John's Wort together in an interaction, co-administration, or pharmacokinetic context.

Limitations

What this evidence cannot tell you.

Search-based evidence indexes have real limits, and it is worth being explicit about them:

NutriStack

Track what you actually take.

NutriStack is a free iPhone app for organising a supplement routine: what you take, when, and what the published record says about it. Its exploratory interaction checker covers Sertraline, St. John's Wort, and several hundred other substances.

The checker is a research and organisation tool, not a clinical decision aid, and its per-pair assessments are excluded from search until they pass claim-level review.

NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.