Does Elderberry interact with Zoloft?(3+ effects)

This article will explore potential interactions between Elderberry and Zoloft (Sertraline), and offer guidance on how to use them safely.

Does Elderberry interact with Zoloft?

Yes, Elderberry does interact with Zoloft. Elderberry is a herbal remedy often used as a supplement in the prevention and management of viral respiratory conditions (1). Zoloft, on the other hand, is a widely prescribed antidepressant for the management of depression (2).

Traditionally, Elderberry has been used for centuries due to its immune-boosting and anti-inflammatory properties. In recent years, Elderberry has gained popularity as a supplement due to its beneficial effects on the coronavirus (1).

Despite its beneficial effects, recent studies have raised concerns about its potential interactions with certain medications, such as Zoloft. These concerns have primarily been associated with Elderberry’s effects on the metabolism of these drugs.

What does research suggest?

There is limited research on the interaction between Elderberry and Zoloft. However, some studies have attributed this interaction to Elderberry’s influence on Zoloft’s metabolism in the liver by Cytochrome P450 (CYP450) enzymes.

Elderberry contains compounds, including flavonoids and anthocyanins, that possess immune-boosting properties (3). These compounds may influence CYP 450 enzymes, particularly CYP3A4 and CYP2C19, related to Sertraline’s metabolism (2,5).

While the exact mechanism remains unclear, Elderberry’s inhibition of these enzymes may inhibit the metabolism of Zoloft, leading to a potentially toxic accumulation of the medication in the bloodstream (5).

This not only reduces the effectiveness of Zoloft but also increases the likelihood of experiencing its side effects and toxicity.

Additionally, a study on drug-induced pancreatitis suggested that antidepressants such as Mirtazapine and Zoloft may have a synergistic effect in causing or worsening drug-induced pancreatitis (4).

Some studies have also proved the novelty and efficacy of elderberry and Zoloft in the management of cancer in some individuals (7,8).

Elderberry has also proven to work synergistically with Zoloft in the treatment and management of depression (2,6).

What are the side effects of taking Elderberry with Zoloft?

The interaction between Elderberry and Zoloft can result in increased Zoloft-induced side effects, like nausea, vomiting, dizziness, drowsiness, insomnia, etc – as Elderberry prolongs the mechanism of action of Zoloft (2,4,5).

The most concerning risk of this interaction is the development of Serotonin syndrome. Both Elderberry and Zoloft influence the levels of serotonin in the body.

When used concurrently, they may cause a toxic accumulation of serotonin, resulting in symptoms such as confusion, increased heart rate, tremors and seizures, which are associated with serotonin syndrome (2,4).

Serotonin syndrome is a life-threatening condition that should be immediately reported and treated.

Additionally, Elderberry and Zoloft both cause gastrointestinal side effects such as nausea, vomiting and diarrhea, independently. When combined, they may increase the likelihood of these side effects.

Elderberries may also cause allergic reactions such as skin rashes, itching and swelling which may exacerbate Zoloft-induced eczema (if present).

Although the mechanism is unclear, the interaction between Zoloft and Elderberries may cause changes in blood sugar levels (3).

What to do if you suspect Zoloft-Elderberry interactions?

Before adding elderberry supplements to your daily routine, you should consult your doctor or pharmacist. They will assess your specific needs, medication dosages, and any potential risk of interactions.

If you are taking Elderberry alongside Zoloft, you should self-monitor for any unusual symptoms or side effects.

If you experience any undesired side effects while using this medication and supplement combination, you should report them promptly and seek guidance from your primary healthcare provider. They will offer personalized guidance based on your specific needs and medication regimen.

While using this combination, it is important to follow your doctor’s instructions carefully to minimize the risks of interactions.

Additionally, if you are concerned about potential interactions, you should discuss alternative remedies with your healthcare provider.


While elderberry is safe when used responsibly, it is important to be aware of its potential interactions with other medications like Zoloft. Your doctor will guide you on the most suitable way to take this supplement alongside other medications.

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Wieland LS, Piechotta V, Feinberg T, Ludeman E, Hutton B, Kanji S, et al. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complementary Medicine and Therapies [Internet]. 2021 Apr 7 [cited 2023 Sep 28];21. Available from:



Singh HK, Saadabadi A. Sertraline [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2023 Sep 28]. Available from:



Młynarczyk K, Walkowiak-Tomczak D, Łysiak GP. Bioactive properties of Sambucus nigra L. as a functional ingredient for food and pharmaceutical industry. Journal of Functional Foods [Internet]. 2018 Jan [cited 2023 Sep 28];40:377–90. Available from:



Weissman S, Aziz M, Perumpail RB, Mehta TI, Patel R, Tabibian JH. Ever-increasing diversity of drug-induced pancreatitis. World Journal of Gastroenterology [Internet]. 2020 Jun 14 [cited 2023 Sep 28];26(22):2902–15. Available from:



Langhammer AJ, Nilsen OG. In vitroInhibition of Human CYP1A2, CYP2D6, and CYP3A4 by Six Herbs Commonly Used in Pregnancy. Phytotherapy Research [Internet]. 2013 Jul 10 [cited 2023 Sep 28];28(4):603–10. Available from:



Patinha S, Murteira JV, Costa CP, Salvador ÂC, Santos SAO, Silvestre AJD, et al. Elderberry Stalks as a Source of High-Value Phytochemical: Essential Minerals and Lipophilic Compounds. Applied Sciences [Internet]. 2022 Jan 1 [cited 2023 Sep 28];12(1):382. Available from:



Duarte D, Vale N. Antidepressant Drug Sertraline against Human Cancer Cells. Biomolecules [Internet]. 2022 Oct 19 [cited 2023 Sep 27];12(10):1513. Available from:



Lamy S, Muhire E, Borhane Annabi. Antiproliferative efficacy of elderberries and elderflowers (Sambucus canadensis) on glioma and brain endothelial cells under normoxic and hypoxic conditions. Journal of Functional Foods [Internet]. 2018 Jan 1 [cited 2023 Sep 28];40:164–79. Available from:,et%20al.%2C%202006).


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