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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Take Lexapro After Recently Taking St. John S Wort For Anxiety?

I have been on 20mg of Lexapro for some time now. However, I recently ran out. I had free Medicare through the state but I no longer and eligible. I do not currently have health insurance. I have been out of Lexapro for about a week and of course have been feeling more anxious..I raed that St John s Wort could help with anxiety. I got a bottle last night and took one 300mg pill. However, my prescription still had one refill left, so I went ahead and just got it and paid out of pocket. is it safe for me to take my Lexapro now or do I need to wait?
Mon, 3 Mar 2025
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General & Family Physician,  's  Response
Hi,

It may be best to wait because of the risk of interaction. The combination of medication can potentially increase the levels of serotonin and increase the risk of a condition called serotonin syndrome. The half life of a medication is the time it takes for the amount of medication in the body to decrease by half and it can take approximately 3 to 5 half lives for a medication to be eliminated though the levels would be continually decreasing.

The half life of St. John's wort would vary according to the amount of the active ingredient and formulation but in general is approximated at 24 to 36 hours, this means that it may take a few days for its levels to decrease. this does not necessarily mean that you would need to wait an extended period of time but at least 36 to 48 hours would be best. Though difficult with the lack of insurance, if possible, you should see a doctor.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Michelle Gibson, General & Family Physician
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Is It Safe To Take Lexapro After Recently Taking St. John S Wort For Anxiety?

Hi, It may be best to wait because of the risk of interaction. The combination of medication can potentially increase the levels of serotonin and increase the risk of a condition called serotonin syndrome. The half life of a medication is the time it takes for the amount of medication in the body to decrease by half and it can take approximately 3 to 5 half lives for a medication to be eliminated though the levels would be continually decreasing. The half life of St. John s wort would vary according to the amount of the active ingredient and formulation but in general is approximated at 24 to 36 hours, this means that it may take a few days for its levels to decrease. this does not necessarily mean that you would need to wait an extended period of time but at least 36 to 48 hours would be best. Though difficult with the lack of insurance, if possible, you should see a doctor. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Michelle Gibson, General & Family Physician