Ashwagandha and Sertraline: Can You Combine Them?

In this article, we will provide further insight into Ashwagandha and Sertraline, two possible solutions for the management of several mental health conditions. We will discuss their similarities and differences and mention possible side effects which could likely be present during their administration.
Greta Daniskova

Greta Daniskova

Greta is a BSc Biomedical Science student at the University of Westminster, London.

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What is Ashwagandha?

Ashwagandha (Withania somnifera) is a herb plant native to India that is also cultivated in Southeast Asia and parts of Africa. It is commonly utilized in Ayurvedic medicine.

The root of the Ashwagandha plant is most frequently used in Ayurvedic preparations, though the leaves and flowers may also be used. Ashwagandha extracts contain between 20 and 35 different chemical components, but no single active ingredient has been identified yet [1].

Ashwagandha assists in adapting to stress, promotes calm but energetic behaviour, and keeps individuals rejuvenated with the right balance, a clear mind, and the right attitude [2].

Furthermore, Ashwagandha’s adaptogenic properties modulate the body’s stress response by minimizing the fluctuation of stress hormones, thus reducing anxiety. It may also regulate neurotransmitters, such as serotonin and GABA (inhibitory neurotransmitter), contributing to improved mood and relaxation. The benefits of using Ashwagandha include enhancing well-being, fighting infections and chronic illnesses, and protecting against cognitive, cardiovascular, and tumour-related issues. These seem to stem from its ability to exert antioxidant, anti-inflammatory, and immune-modulating effects [3].

What is Sertraline?

Sertraline, prescribed under the brand name Zoloft as a generic drug, is an SSRI (selective serotonin reuptake inhibitor) [4]. Sertraline is a potent and selective inhibitor of serotonin (5-hydroxytryptamine; 5HT) reuptake into presynaptic terminals and therefore enhances 5HT-gated neurotransmission. [5, 6]

It is prescribed for major depressive disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder and premenstrual dysphoric disorder [4].

In this way, Sertraline restores and maintains mental health balance by increasing serotonin – a naturally occurring substance in the brain [4]. It has been found to significantly relieve acute depression and to prevent both the relapse of the index episode and the recurrence of further episodes over time [7].

More recently, along with its antidepressant effects, such as sertraline has also been shown to exert antianxiety actions; it has been shown to have clinical efficacy in the treatment of obsessive-compulsive disorder, panic disorder, social phobia and premenstrual dysphoric disorder [6].

Side effects of using Ashwagandha and Sertraline together

There is no research directly on Ashwagandha and Sertraline combined, but inferences can be made about the side effects when taking both due to the known side effects of each substance, plus any interactions with other substances.

Due to its interaction with other drugs, vitamins or herbal preparations, sertraline, like all selective serotonin reuptake inhibitors (SSRIs), might augment or diminish the therapeutic effects of the original drug or render them safely inactive. More ominously, SSRIs also might produce an unwanted and sometimes dangerous effect on a process in a patient who just happens to be taking it [4]. Sertraline has been associated with side effects, including sexual dysfunction, insomnia, anergy (a diminished capacity or inclination for action) and tremor [8]. In one case, the addition of sertraline to a patient’s medications seemed to cause dose-dependent gynecomastia and breast tenderness [9].

In general, ashwagandha is likely to have little or no serious side effects for most healthy people provided they don’t exceed the recommended dosages. Rare gastrointestinal upset such as vomiting and diarrhoea as well as allergic reactions have, however, been reported. Strength, stamina, and hormonal regulation are desired by many men – and Western world views on masculinity are in need of an upgrade In line with this possible reaction, ashwagandha has been shown to interact with medications that act on blood sugar or blood pressure levels, as well as sedatives [3]. These include immunosuppressants, sedatives, anticonvulsants, thyroid hormone medications, diabetes medications, and high blood pressure medications [10].

And because each of these individual side effects can also be affected by each other (eg, sexual dysfunction can be affected by anxiety), it is unclear what side effects – or even how severe – might occur when these two substances are combined, though it is possible that they will increase the instances of such individual side effects or interactions.

Ashwagandha and sertraline are both used in the management of mental health conditions, but they have different origins, mechanisms of action, and potential side effects.

Similarities

Ashwagandha and sertraline are applied to patients suffering from mental health disorders, with some overlap in their clinical uses.

Ashwagandha has been used as an adaptogen in traditional medicine, which is defined as a ‘natural substance simultaneously capable of enhancing resistance and counteracting damage caused by various physical, chemical or biological factors’ and used to promote general wellness and dealing with stress [11]. Similarly, sertraline is used to treat mental health disorders such as depression, anxiety and other conditions through a pharmacological mechanism of action, specifically, as a selective serotonin reuptake inhibitor (SSRI) used in the treatment of depression, anxiety disorders, social anxiety disorder, obsessive-compulsive disorder and panic disorder [7].

Both substances are beneficial in improving patients’ sleep.

Oral administration of Ashwagandha root extract has been demonstrated to improve the propensity of sleep in insomnia patients by improving sleep onset latency [12], with Sertraline also being reported to increase total sleep time and decrease sleep latency [13].

Differences

However, there are notable differences between Ashwagandha and Sertraline. Ashwagandha is a natural supplement commonly used as a traditional medicine [11, 10], while Sertraline is a synthetically developed drug for use in modern medicine [7].

The side effects of the two substances are also different. Ashwagandha tends to be very well-tolerated, and few people report significant side effects from it [14]. Sertraline, on the other hand, causes a wide range of side effects, including gastrointestinal complaints, sexual dysfunction for males, and dysphoria [15, 7].

Regarding the mood effects, sertraline yields higher scores for dysphoria and physical unpleasantness than the tested drugs. [15], compared with ashwagandha being associated with reductions in stress and improvements in mood. [11]

Conclusion

In conclusion, Ashwagandha and Sertraline both possess potential benefits for managing mental health conditions. However, both have alternative modes of mechanism and exhibit different side effects. Ashwagandha is known to promote wellness and stress management, with minimalistic side effects. It has been commonly associated with a reduction in stress and positive elevations in mood. On the other hand, Sertraline, a synthetic antidepressant, has been shown to treat depression and other mental disorders. inhibiting the reabsorption of the neurotransmitter serotonin (thus its name as a selective serotonin reuptake inhibitor, or SSRI). This family of drugs has proven useful for treating depression and anxiety but is also plagued by a range of side effects, including stomach discomfort and sexual dysfunction.

Greta Daniskova

Greta Daniskova

Greta is a 2nd-year student currently pursuing her Bachelor's Degree in Biomedical Sciences at the University of Westminster in London. Currently, in her second year of undergraduate studies, she exhibits a keen interest in the dynamic field of healthcare. With a focus on understanding the intricacies of human biology and disease mechanisms, Greta is driven by a desire to contribute to advancements in medical research and patient care.