Ashwagandha and Zoloft: A Combo to Boost Mental Health?

Ashwagandha has become a herbal supplement hit in recent years, its indications expanding beyond enhancing wellness to treating mental health problems. However, not much is known about how ashwagandha works throughout the body. In this article, we will cover the research on how ashwagandha interacts with Zoloft, a common SSRI antidepressant, and whether ashwagandha could replace Zoloft in mental health care.
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

A blue image with text saying "Ashwagandha and Zoloft"

How Does Ashwagandha Work?

Ashwagandha is a popular herb with adaptogenic properties, beneficial across a spectrum of health conditions and biological functions [1]. It is believed to work by regulating the body's stress response through its adaptogenic properties, helping to balance stress hormone levels and reduce anxiety [2, 3].

Ashwagandha can modulate neurotransmitters, such as serotonin and GABA, contributing to improved mood and relaxation. This modulation of neurotransmitters can have a positive impact on mental health symptoms such as anxiety, low mood, stress, sleep and obsessive-compulsive disorder (OCD) [4, 5].

Ashwagandha reduces inflammation, modulates the immune system and has antioxidant properties that improve health across a spectrum of systems. For example, anti-inflammatory and antioxidant properties can protect against neurodegenerative conditions, or cancer. Some research suggests it can be benefical for PCOS, as we discussed in our blog about Ashwagandha and Polycystic ovarian syndrome (PCOS) [1].

Ashwagandha extracts can contain up to 35 unique chemicals, including steroidal alkaloids and lactones, which contribute to its therapeutic effects [5]. The specific way that Ashwagandha achieves its broad-spectrum benefits is still under investigation, and we currently only have a small number of studies [1].

How Does Zoloft Work?

Zoloft is medication primarily used to treat depression and anxiety [6].

Specifically, Zoloft belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Zoloft, therefore, works by increasing the levels of serotonin, a critical regulator of mood, appetite, and alertness, in your brain. SSRIs block serotonin's reuptake (re-absorption) and increase the amount of free serotonin in the brain. Due to the role of serotonin in the brain, increasing serotonin can improve mood and reduce anxiety [6]. It's worth noting that Zoloft doesn't cure the conditions it's used to treat, but it can help manage the symptoms.

What are Ashwagandha and Zoloft Used for?

Zoloft, a prescription SSRI, is most frequently used to treat depression, social anxiety, premenstrual dysphoria, panic disorder and even post-traumatic stress disorder. Zoloft has been FDA-approved for these disorders, indicating it is safe and more efficacious than placebo in these conditions [6].

Ashwagandha has been an essential herb in Ayurveda, a form of traditional Indian medicine, for thousands of years. Ashwagandha has primarily been used to reduce stress and anxiety, improve energy, reduce fatigue, ease pain, and decrease inflammation [1].

Nonetheless, Ashwagandha is not an FDA-approved treatment for any of these indications. This is because it is an herbal supplement which is not regulated by the FDA [7]

Despite not being FDA-approved, Ashwagandha has been found to have a wide range of applications in mental health conditions. These include conditions similar to those Zoloft is prescribed for [8]. Ashwagandha is often used to relieve stress, support mental health, and improve sleep and brain function [1]. Ashwagandha has recently shown benefits in obsessive-compulsive disorder (OCD), a debilitating mental health condition characterised by compulsive thoughts and obsessive behaviours [9, 10].

Do Ashwagandha and Zoloft Interact?

There isn’t yet sufficient evidence to determine exactly whether Ashwagandha and Zoloft pharmacologically interact. However, based on the available information - Ashwagandha can interact with antidepressant drugs, including Zoloft.

The most significant risk reported with Zoloft prescription is Serotonin syndrome, which can occur when there is too much serotonin in the brain. This is why doctors avoid prescribing more than one SSRI. As the therapeutic actions of Ashwagandha are not fully clear, there is a small risk that ashwagandha and Zoloft taken concurrently increase the risks of serotonin syndrome.

Empirically, only one study looked at the tolerability of ashwagandha and SSRIs, such as Zoloft. This study found only one participant experiencing disruptive side effects of diarrhoea [11]. Surprisingly, the adverse events occurring with Zoloft and over-the-counter non-prescription drugs were lower than the adverse events after antidepressants combined with adaptogens [12, 11]. This highlights the importance of caution and careful consideration when combining herbal supplements with prescription drugs. Ensure you report all supplements and medications you are taking or intend to take to your medical professional.

Summary: Are Ashwagandha and Zoloft a Beneficial Combo?

To summarise, there is good evidence to support the stress-relieving benefits of ashwagandha and even preliminary evidence to indicate it can be used for depression and anxiety. As an herbal supplement, Ashwagandha is not an FDA-approved treatment for these conditions and may not provide sufficient symptom relief. While it is likely to be safe to take Ashwagandha and Zoloft concurrently, there are reported risks of side effects.

Given the potential for interactions, it's always a good idea to consult a healthcare professional before combining Ashwagandha with Zoloft or any other medication. Likewise, if you experience symptoms of anxiety or depression, see a healthcare professional and do not self-medicate with ashwagandha.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.