Does Cinnamon Interact with Zoloft? (+3 Interactions)

In this article, we will discuss whether Cinnamon, a spice obtained from the bark of Cinnamomum verum or Cinnamomum zeylanicum tree, reacts with Zoloft (Sertraline), a selective serotonin reuptake inhibitor drug used as an antidepressant. This article further explores five critical insights on the potential interactions, consequences, and considerations when using cinnamon and sertraline together. 

Does Cinnamon Interact with Zoloft? 

Yes. When used together, cinnamon and Zoloft (Sertraline) interact in their antidepressive, antidiabetic and antiinflammatory activity in a synergy that induces more pronounced effects. 

Zoloft (Sertraline) is an antidepressant medication under the pharmacological class of selective serotonin inhibitors (SSRI). The drug has been approved for use in major depression, social anxiety disorder, premenstrual dysphoric disorder and post-traumatic stress disorder (1). Cinnamon is an herb or species obtained from the inner bark of the Cinnamomum verum tree (Synonym: Cinnamomum zeylanicum). 

Are there any Potential Interactions

Zoloft works by selectively inhibiting the reuptake of serotonin, the happy hormone, at the presynaptic neural membrane. This increases serotonergic activity in the brain and alleviates depressive symptoms (1). Apart from its role in depression, serotonin also induces hypoglycemia (1). Sertraline has also been shown to regulate pro-inflammatory cytokines (2). 

Cinnamon on the other hand has been used as a spice and medicine over the years (3).  Cinnamon has been shown to help manage symptoms associated with inflammation, diabetes,  cancer, dyslipidemia, Alzheimer’s disease and parkinsonism (4).

Cinnamon has also illustrated antidepressive activity through its ability to increase brain-derived neurotrophic factor (BDNF) (5). Depressed people have a lower BDNF compared to other populations. All these medicinal benefits stem from the presence of phytochemicals with potential medical activity in the bark.

The chemicals include coumarins, alkaloids, flavonoids, terpenoids, betacyanins and cardiac glycosides (4). 

Interaction #1: Increased Risk of Serotonin Syndrome

First, both Cinnamon and Sertraline have been shown to possess anti-depressive activity as they mediate different neuronal pathways (1,5). Although their relative pharmacological action has not been tested, potential synergism may exist especially in high doses of administration. Synergism may increase the likelihood of developing adverse effects. People taking Cinnamon and Sertraline should watch out for adverse effects which include; fever, shivering, diarrhoea, muscle rigidity and seizures (1). 

Interaction #2: Altered Blood Sugar Levels

Secondly, considering that both Sertraline and Cinnamon possess antidiabetic effects. Sertraline decreases blood sugar by increasing serotonin which mediates an increased release of insulin. Cinnamon decreases blood sugar by decreasing insulin resistance (5). This combined synergism may alter blood sugar levels substantially. 

Interaction #3: Potential Impact on the Liver

Third, both Cinnamon and Setralline are metabolized by cytochrome p450 in the liver. Taking both medicines together makes them compete for cytochrome p450 which leads to higher drug concentrations in the blood. This further increases the risk of side effects. 

What does research say? 

Studies have established that cinnamon can interact with selective serotonin reuptake inhibitors since they both possess anti-depressant activity (6). In one study conducted on fifty patients with major depression, sertraline 100mg twice daily plus 500mg cinnamon once daily was administered for six weeks (6). Evaluations using the HAM-D score show improved efficacy of the regimen in managing depression symptoms compared to each medication individually. The study concluded that cinnamon can be used as an adjuvant therapy in the management of depression. 

In another study, forty-one female patients with major depressive disorder reported symptoms that were consistent with SSRI sexual dysfunction after treatment with sertraline in therapeutic doses (7). They were randomly assigned to treatment with a herbal concoction containing cinnamon and a placebo. Results show marked improvements in depression symptoms for patients who were administered with cinnamon. This study also proves an interaction between sertraline and cinnamon. 

What are the Precautions and Recommendations for Cinnamon and Zoloft Users?

While cinnamon’s interaction with Sertraline (Zoloft) is through a positive synergism on anti-depressive and antidiabetic symptoms, it is crucial to examine other factors. For example, using Sertraline and Cinnamon together may decrease blood sugar to unanticipated levels. Users of these two medicines should be aware of this and keep a close eye on their blood sugar levels.

Cinnamon is also a frequently utilized spice in culinary dishes and beverages. Consider the overall content of your diet if you’re taking Sertraline (Zoloft). A balanced and healthy diet that includes cinnamon in moderation is generally safe. 

How much cinnamon is too much when taking sertraline?

Although cinnamon has proven to possess antidepressant activity, consumption of low amounts may not precipitate any pharmacological effects. Consuming cinnamon at more than 100mg/kg body weight has been proven to cause antidepressant effects (8). The effects caused by this amount of cinnamon ingestion have been deemed similar to that of fluoxetine, a medication in the same class as sertraline (8).

Cosidering that sertraline is slowly absorbed in the gastrointestinal tract, consuming it with cinnamon but at differet times of the day is unlikely to yeild any different results. Although cinnamon is not necessarily a prescription medication, it is advisable to consult your healthcare provider before starting on cinnamon when taking sertraline. This will minimize the likelihood of severe adverse effects like hypoglycemia. 

Conclusion

The synergistic interactions between Cinnamon and Setralline on depression and hyperglycemia cannot be overlooked. Consuming high levels of Cinnamon while taking Sertraline may increase the likelihood of developing severe dose-related side effects; not to forget hypoglycemia caused by the interaction.

While it is evident that taking sertraline and cinnamon increases the antidepressant effects of the two medications, I would recommend consulting a healthcare provider before starting the regimen. This way, the healthcare provider can ensure blood sugar levels are in check and advise on stopping or reducing medication dosage when necessary. If you notice any odd symptoms or side effects when taking Cinnamon with Sertraline (Zoloft), contact your doctor right away. 

References