Supplement × Prescription·contraindicated·Moderate evidence
St. John's Wort has serotonergic effects and can also induce CYP3A4, making both toxicity and loss of antidepressant control possible.
Every entry follows the same shape: what is happening, the mechanism, and the recommendation.
What is happening. St. John's Wort has serotonergic effects and can also induce CYP3A4, making both toxicity and loss of antidepressant control possible.
Mechanism. Additive serotonergic activity increases serotonin syndrome risk; CYP3A4 induction can lower vilazodone exposure after repeated use.
Recommendation. Do not combine St. John's Wort with vilazodone.
Effect on the composite score
If both St. John's Wort and Vilazodone are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are at /methodology/stack-score.
Every claim on this page is cited. PMIDs link straight to PubMed.
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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.
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