The short answer
Discuss SAMe with the prescriber before using it with citalopram. Official guidance raises a possible serotonergic interaction, although an exact-pair serotonin-syndrome rate is unknown.
What this answer covers
Oral S-adenosylmethionine supplement; concentrated supplement distinct from ordinary dietary nutrients.
- Supplement or preparation
- S-Adenosylmethionine
- Medication ingredient
- citalopram
Why review is reasonable
NCCIH cautions that SAMe may interact with medicines increasing serotonin. Citalopram has a serotonin-syndrome warning, although its label does not specifically name SAMe.
Clinical use is not universal safety proof
A small SAMe add-on trial in people taking serotonin-reuptake inhibitors found benefit. It does not establish citalopram-specific risk or rule out uncommon reactions.
Include mood history in the review
SAMe guidance highlights bipolar disorder concerns. Bring the complete supplement label and mood history before adding it.
Recognize concerning symptoms
Seek urgent medical care for a combination of agitation or confusion, fever or heavy sweating, tremor, muscle rigidity or repeated twitching. These can be signs of serotonin syndrome; a single nonspecific symptom does not establish the diagnosis.
Evidence and practical considerations
Side effects & toxicity
Conditional serotonergic review, with no demonstrated citalopram-specific event rate.
- Exact scope
- Oral S-adenosylmethionine supplement; concentrated supplement distinct from ordinary dietary nutrients. with Exact oral citalopram hydrobromide film-coated tablets. RxNorm IN2556 / PIN221078 hydrobromide tablets. Racemic citalopram is distinct from escitalopram.
- Medication form and route
- oral
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- Mixed antidepressant augmentation evidence does not isolate citalopram safety.
Factors that may matter: preparation and plant part; clinical indication; dose; other medicines; baseline alertness.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed oral citalopram.
Label names tryptophan and St John’s wort in serotonin warnings; dose-dependent QT and electrolyte precautions are distinct from sedation and nutritional augmentation.
How this applies: RxNorm IN2556 / PIN221078 hydrobromide tablets. Racemic citalopram is distinct from escitalopram.
No universal supplement interval, event rate or preparation equivalence established.
Source 2: official supplement guidance
nccih.nih.gov · Source check Sep 10, 2026
Population: People considering SAMe.
Possible interaction with serotonin-increasing medicines and supplements; bipolar disorder and limited long-term safety warrant review.
How this applies: Supplement-only precaution, applied conditionally with the citalopram label.
General possible serotonergic interaction and bipolar precautions; no citalopram-specific event rate.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 73 serotonin reuptake inhibitor nonresponders with major depression.
Response and remission favored SAMe; discontinuation due to adverse events was not significantly different.
How this applies: Indirect treatment context, not citalopram-specific safety or efficacy proof.
Mixed serotonin-reuptake-inhibitor trial; citalopram-specific exposure and outcomes not established from inspected text.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Current exact available claims adjudicated using original captures and explicit identity and comparator limits. | |
| Research summary published |
Article revision: 614fcfd7c28c8d87
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.