Selective Serotonin Reuptake Inhibitors for Premature Ejaculation: Do SSRIs Help?

Selective serotonin reuptake inhibitors (SSRIs) can delay ejaculation in some men with premature ejaculation (PE) by increasing serotonergic signalling and strengthening inhibitory control over the ejaculation reflex. In the UK, dapoxetine is the short acting SSRI specifically licensed for on-demand treatment of PE. For adult men in the UK looking into prescription treatment options, that makes SSRIs a clinically relevant option to understand, but the relationship is more complex than the common claim that premature ejaculation is simply caused by “low serotonin”.

Serotonin, also called 5-hydroxytryptamine or 5-HT, is a neurotransmitter involved in communication between nerve cells. Within the pathways controlling ejaculation, serotonin generally has an inhibitory effect, meaning increased serotonergic activity can make the ejaculation reflex more difficult to trigger.

Different serotonin receptors can have different effects. Activity at receptors including 5-HT2C and 5-HT1B appears to inhibit ejaculation, while 5-HT1A signalling may have a more facilitating effect. Researchers have therefore proposed that differences in serotonin transmission, receptor sensitivity or serotonin transporter function could contribute to lifelong PE in some men.

That does not mean everyone with PE has a measurable serotonin deficiency. There is no routine serotonin blood test used to diagnose premature ejaculation. Current clinical assessment depends mainly on ejaculation timing, perceived control, consistency of symptoms, distress and medical or psychological history.

This guide explains how SSRIs for premature ejaculation work, what the clinical evidence shows, which medicines are licensed or used off-label, how PE is assessed, why serotonin testing and supplements have limits, and what side effects and treatment considerations men in the UK should weigh before seeking care.

Key things to know

Serotonin appears to help inhibit the ejaculation reflex, but the biology of PE involves several neurological, psychological and medical factors.

The phrase “low serotonin causes premature ejaculation” is an oversimplification. Researchers have proposed differences in serotonin transmission and receptor sensitivity as possible contributors, particularly in lifelong PE, but a simple low blood-serotonin diagnosis is not established.

SSRIs have clinical evidence for improving ejaculation control and delaying ejaculation. However, the type of SSRI matters because dapoxetine is specifically designed for on-demand PE treatment, while medicines such as paroxetine, sertraline and fluoxetine are primarily antidepressants and their use specifically for PE is generally off-label.

What Is Serotonin?

Serotonin is a chemical messenger used by the nervous system.

It influences several processes, including:

• Mood
• Sleep
• Appetite
• Anxiety
• Pain processing
• Gastrointestinal function
• Ejaculation.

Serotonin does not have one single effect throughout the body.

Its effects depend partly on which serotonin receptor is activated and where that receptor is located.

This is particularly important when discussing premature ejaculation because different serotonin receptors can influence the ejaculation reflex in different directions.

What Does Serotonin Do During Ejaculation?

Serotonin generally acts as an inhibitory regulator of ejaculation.

The ejaculation reflex involves communication between:

• The brain
• Spinal cord
• Autonomic nervous system
• Pelvic nerves
• Muscles involved in ejaculation.

Serotonergic pathways descending from the brain help regulate this reflex, and specific brain areas are involved in that control.

Greater inhibitory serotonergic activity can raise the threshold required for ejaculation to occur. It is a reflex that sexual arousal and neural signals can trigger ejaculation.

This is one of the reasons medicines that enhance serotonin signalling can delay ejaculation, alongside interactions with other signalling systems such as nitric oxide.

Does Serotonin Help With Premature Ejaculation?

Serotonin itself is not normally given directly as a treatment for PE.

But medicines that increase serotonin signalling can help some men delay ejaculation.

SSRIs are the best known example of this.

These medicines block the serotonin transporter responsible for taking serotonin back into nerve cells after it has been released.

As a result, serotonergic activity between nerve cells is increased or prolonged.

Over time, this can strengthen the inhibitory pathways controlling ejaculation and make the ejaculation reflex more difficult to trigger.

Does Low Serotonin Cause Premature Ejaculation?

It is more accurate to say that reduced serotonergic inhibition may contribute to PE in some men than to say that low serotonin directly causes the condition.

Research has proposed several possible mechanisms.

These include:

• Reduced serotonin neurotransmission
• Reduced sensitivity of inhibitory 5-HT2C receptors
• Increased sensitivity of 5-HT1A receptors
• Differences in serotonin-transporter function
• Genetic differences affecting serotonin signalling.

These theories are particularly relevant to lifelong premature ejaculation.

However, no biological mechanism has been proven to explain PE in every affected man.

Premature ejaculation is a multifactorial condition, with psychological issues such as anxiety and early sexual experiences, and physical causes such as chronic prostatitis and diabetes mellitus, all potentially contributing.

Why “Low Serotonin” Is Too Simple an Explanation

The amount of serotonin circulating in the blood is not the same thing as serotonin activity within the brain and spinal pathways involved in ejaculation.

Someone could therefore have a particular blood serotonin measurement without it accurately representing:

• Serotonin release within the central nervous system
• Receptor sensitivity
• Serotonin transporter activity
• The balance between different 5-HT receptors.

This is why PE is not diagnosed by simply checking whether someone's serotonin level is “low”.

Can You Test Serotonin Levels for Premature Ejaculation?

Routine serotonin testing is not recommended for diagnosing premature ejaculation.

Some research studies have measured blood serotonin levels and investigated whether they differ between men with and without PE.

However, those experimental findings have not resulted in serum serotonin becoming a standard clinical diagnostic test.

Current PE assessment is primarily clinical, because PE is a form of male sexual dysfunction within the broader category of sexual dysfunction.

Ejaculation problems are a common reason men seek assessment, and doctors may consider:

• How long the problem has been present
• Whether it is lifelong or acquired
• Perceived ejaculation control
• How consistently it occurs
• Distress or relationship impact
• Erectile function
• Medical history
• Psychological factors.

Authoritative definitions have shifted toward an evidence based unified definition linked to the International Society for Sexual Medicine, the international society behind these criteria, whereas earlier definitions from the American Psychiatric Association in the Diagnostic and Statistical Manual and wider statistical manual framework did not have the same evidence base.

Current clinical definitions also assess latency after vaginal penetration, together with control and distress, including negative personal consequences that can affect sexual intimacy.

Laboratory investigations are generally directed towards suspected underlying conditions rather than routinely testing serotonin.

What Is the Role of 5-HT1A in Premature Ejaculation?

The 5-HT1A receptor appears to have a more complicated role than simply delaying ejaculation.

Activation of certain 5-HT1A receptors can reduce serotonergic neuronal activity and decrease serotonin release.

This can reduce some of serotonin's inhibitory control over ejaculation.

Researchers have therefore proposed that increased 5-HT1A sensitivity could lower the ejaculation threshold in some men.

This forms part of one biological model of lifelong PE.

What Is the Role of 5-HT2C?

The 5-HT2C receptor appears to have an inhibitory role in ejaculation.

Greater activation of this receptor is associated with stronger inhibition of the ejaculation reflex and longer ejaculation latency.

Researchers have proposed that reduced 5-HT2C receptor sensitivity could make ejaculation easier to trigger.

This is one possible explanation for why SSRIs, which ultimately enhance serotonergic signalling, can delay ejaculation.

What Are Selective Serotonin Reuptake Inhibitors?

Selective serotonin reuptake inhibitors, or SSRIs, are medicines that reduce the reabsorption of serotonin into nerve cells.

They were primarily developed for conditions such as:

• Depression
• Anxiety disorders
• Obsessive-compulsive disorder
• Other mental-health conditions.

A well-recognised effect of SSRIs is delayed ejaculation.

Doctors and researchers therefore began using this effect therapeutically in men with premature ejaculation. Prevalence estimates of premature ejaculation range from 22% to 38%. About 21% of men in the US experience it, and one survey reported 22.7% of men with the condition.

How Do SSRIs Help Premature Ejaculation?

SSRIs block serotonin transporters.

Normally, serotonin released from a nerve cell is eventually taken back into that cell through a serotonin transporter.

Blocking this process leaves serotonin available between nerve cells for longer.

With repeated treatment, serotonergic signalling changes further as serotonin receptors adapt.

The eventual result can be greater inhibitory control over the ejaculation reflex.

This may help:

• Increase ejaculation latency
• Improve perceived control
• Reduce PE-related distress
• Improve treatment satisfaction.

Do SSRIs Actually Work for Premature Ejaculation?

Yes, there is evidence from placebo controlled research, including double blind designs, supporting their effectiveness.

A major clinical study review involving 31 randomised studies and more than 8,000 men found that SSRIs improved several outcomes compared with placebo.

These included:

• Overall PE symptoms
• Perceived ejaculation control
• Treatment satisfaction
• Distress related to PE.

The review also found an average increase in ejaculation latency, although the certainty of evidence for the exact amount of time gained was lower than for some patient-reported outcomes.

SSRIs also produced more adverse effects than placebo.

This means effectiveness needs to be balanced against tolerability, and at the treatment stage it is worth noting that only 9% of men with premature ejaculation consult a physician.

Which SSRIs Are Used for Premature Ejaculation?

Several SSRIs have been used for PE.

They include:

Dapoxetine
A short-acting SSRI specifically developed for on-demand PE treatment.

Paroxetine
A longer-acting SSRI primarily licensed as an antidepressant but used off-label for PE.

Sertraline
Another antidepressant SSRI sometimes prescribed off-label for PE.

Fluoxetine
Also primarily an antidepressant and sometimes used off-label.

A double blind trial may compare these options individually, but all the SSRIs studied for PE appear to show a class effect, even though efficacy and tolerability differ.

Tricyclic antidepressants have also been studied historically, but the focus here remains on SSRIs.

The appropriate choice depends on medical history, symptoms, other medicines and the clinical treatment strategy.

Is Dapoxetine an SSRI?

Yes.

Dapoxetine is a short-acting selective serotonin reuptake inhibitor.

Unlike conventional SSRIs that were developed primarily as antidepressants, dapoxetine was developed with a short pharmacokinetic profile suitable for on-demand treatment of premature ejaculation.

It increases the time to ejaculation and can improve perceived control.

Is Dapoxetine Licensed for Premature Ejaculation in the UK?

Yes.

Dapoxetine is licensed in the UK for premature ejaculation in eligible adult men aged 18 to 64 years.

The recommended starting dose is generally 30mg, taken 1 to 3 hours before anticipated activity.

Dapoxetine reaches peak plasma concentration within one hour.

If the response to 30mg is insufficient and treatment is well tolerated, a clinician may consider 60mg.

Dapoxetine should not be taken more than once within 24 hours and is not intended as an everyday medicine.

For some men, topical anaesthetics can reduce penile sensitivity to delay ejaculation, which may be another effective treatment option for rapid ejaculation depending on the clinical picture.

How Quickly Does Dapoxetine Work?

Dapoxetine is designed to work much faster than conventional daily SSRIs.

It is generally taken 1 to 3 hours beforehand.

This allows it to be used when needed rather than requiring continuous daily exposure or chronic treatment.

That short-acting profile is one of the reasons it is different from paroxetine, sertraline or fluoxetine when these medicines are used for PE.

What Are the Side Effects of Dapoxetine?

Recognised side effects can include:

• Nausea
• Dizziness
• Headache
• Diarrhoea
• Difficulty sleeping
• Tiredness.

Although dapoxetine is used in the UK under local prescribing and licensing standards, it is not FDA approved in the United States.

Antidepressants used for PE can also cause sexual side effects affecting libido, erection, orgasm, or ejaculation.

Problems such as delayed ejaculation, anorgasmia, or difficulty ejaculating may also be discussed more broadly as ejaculatory dysfunction.

Dizziness and fainting are particularly important considerations.

People prescribed dapoxetine should follow the medicine instructions carefully and take it with a full glass of water.

Young adults treated with antidepressants may also need monitoring for suicidal thoughts or behavioural changes.

It is not suitable for everyone, including some people with certain heart, liver or psychiatric conditions or significant medicine interactions.

Can Dapoxetine Cause Fainting?

Yes.

Fainting and blood-pressure changes can occur with dapoxetine.

This is one reason a medical assessment is necessary before treatment.

Someone with a history of unexplained fainting or certain cardiovascular conditions may not be suitable for dapoxetine.

Are Paroxetine, Sertraline and Fluoxetine Licensed for PE?

Their use specifically for premature ejaculation is generally off-label in the UK.

“Off-label” does not mean illegal or automatically unsafe.

It means the medicine is being prescribed for a purpose or regimen outside its specific marketing authorisation.

A clinician can prescribe medicines off-label when there is appropriate evidence and the treatment is considered suitable.

However, current UK specialist opinion places particular emphasis on the licensed on-demand option dapoxetine rather than automatically starting long-term daily antidepressants for PE, because chronic treatment may raise more concerns about withdrawal and sexual side effects than on-demand use.

Why Do Daily SSRIs Take Longer to Work for PE?

Conventional SSRIs do not usually produce their full ejaculation-delaying effect immediately.

The serotonin transporter is inhibited early, but the nervous system subsequently adapts through changes in serotonin-receptor sensitivity.

This process takes time.

Some improvement may appear within several days, but the full ejaculation-delaying effect commonly develops after around one to two weeks of daily treatment.

This is very different from dapoxetine, which is designed for on-demand use.

Which Daily SSRI Delays Ejaculation the Most?

Research comparing conventional SSRIs has often found paroxetine to produce one of the largest ejaculation-delaying effects.

However, this does not automatically make paroxetine the best PE treatment.

Treatment choice also needs to consider:

• Side effects
• Withdrawal symptoms
• Other medicines
• Mental-health history
• Fertility plans
• How frequently treatment is required
• Whether licensed alternatives are appropriate.

A larger average delay is only one part of treatment selection.

Can Sertraline Help Premature Ejaculation?

Yes, sertraline has evidence showing that it can delay ejaculation in men with PE.

However, sertraline is primarily an antidepressant and its use specifically for PE is generally off-label.

It usually requires repeated treatment rather than functioning like an immediate on-demand medicine.

A prescriber should decide whether its potential benefits outweigh its disadvantages for the individual patient.

Can Fluoxetine Help Premature Ejaculation?

Fluoxetine has also been studied and can delay ejaculation.

Like sertraline and paroxetine, it is primarily an antidepressant rather than a medicine specifically licensed for PE.

Its use for PE is therefore generally off-label.

Do SSRIs Work if You Do Not Have Depression?

Yes.

The ejaculation-delaying effect of SSRIs does not require a person to have depression.

SSRIs affect serotonin signalling regardless of whether they are being used to treat a mood disorder.

This is why the same medicine class can have different clinical applications.

However, using an antidepressant solely for PE still requires an appropriate risk-benefit assessment.

Do SSRIs Increase Serotonin Levels?

SSRIs increase the availability and activity of serotonin at nerve-cell synapses by blocking serotonin reuptake.

It is more accurate to describe this as increasing serotonergic signalling than simply saying they “increase total body serotonin”.

The relevant clinical effect occurs within complex nerve pathways and receptors.

This distinction is especially important for PE because changing a blood serotonin measurement is not the treatment objective.

Does More Serotonin Always Mean Better Ejaculation Control?

No.

Serotonin signalling is complex.

Different serotonin receptor subtypes can produce different effects.

For example:

5-HT2C activity tends to inhibit ejaculation.

5-HT1A activity can facilitate ejaculation under some circumstances.

The therapeutic effects of SSRIs therefore involve changes in an entire serotonergic signalling system rather than simply increasing one numerical serotonin value.

Can SSRIs Delay Ejaculation Too Much?

Yes.

The same mechanism that helps PE can sometimes produce excessive delay.

Possible effects include:

• Delayed ejaculation
• Difficulty ejaculating
• Inability to ejaculate
• Reduced libido
• Erection difficulties.

Treatment therefore needs to balance greater ejaculation control against unwanted inhibition of normal function.

What Are the Common Side Effects of Daily SSRIs?

Depending on the medicine, possible effects can include:

• Nausea
• Diarrhoea
• Tiredness
• Drowsiness
• Sweating
• Dry mouth
• Sleep disturbance
• Headache.

Some people may also experience changes in:

• Libido
• Erectile function
• Ejaculation
• Orgasm.

Side effects may improve during the first few weeks, but persistent symptoms should be reviewed.

Can You Suddenly Stop a Daily SSRI Used for PE?

Usually not without medical advice.

Conventional daily SSRIs can produce withdrawal symptoms when stopped abruptly or reduced too quickly.

Possible withdrawal symptoms include:

• Dizziness
• Nausea
• Headache
• Anxiety
• Sleep disturbance
• Unusual sensory symptoms.

Someone taking a daily SSRI should therefore discuss discontinuation with their prescriber.

A gradual dose reduction may be needed.

Is Dapoxetine Withdrawal the Same?

Dapoxetine has a shorter half-life and is used on demand rather than as a conventional continuous antidepressant.

It therefore has a different withdrawal profile from regular daily SSRIs.

However, it should still be used according to prescribed instructions and treatment should be reviewed periodically.

Can SSRIs Make Premature Ejaculation Come Back After Stopping?

Yes.

SSRIs can control PE while treatment is being used, but they do not necessarily permanently change the underlying ejaculation pattern.

Symptoms may return after treatment is discontinued.

This is why medication should generally be described as treatment or management, rather than a guaranteed permanent cure.

Are SSRIs the First Treatment for Premature Ejaculation?

Guidance varies somewhat according to the clinical organisation and whether PE is lifelong or acquired.

European guidance recognises on-demand dapoxetine as an established first-line pharmacological treatment.

The 2025 British Society for Sexual Medicine position statement specifically favours licensed on-demand dapoxetine over routinely using daily off-label SSRIs.

Longer-acting daily SSRIs can nevertheless be considered in selected patients when an appropriate clinician judges them suitable.

For acquired PE, identifying and treating underlying conditions such as erectile dysfunction, prostatitis, anxiety or thyroid disease is particularly important.

What if Premature Ejaculation Is Caused by Another Condition?

Changing serotonin signalling is not always the most important first step.

Acquired PE can occur alongside:

• Erectile dysfunction
• Prostatitis
• Thyroid disorders
• Anxiety
• Relationship problems
• Other medical or psychological changes.

Where another condition appears to be contributing, treating that condition may improve the ejaculation problem.

This is why PE should not automatically be treated as a serotonin deficiency.

Can Erectile Dysfunction Affect Premature Ejaculation?

Yes.

PE and erectile dysfunction can occur together.

A man worried about losing an erection may begin rushing, which can reduce ejaculation control.

In that situation, the erectile difficulty may need to be addressed rather than assuming serotonin is the only relevant factor.

Are Serotonin Supplements Good for Premature Ejaculation?

There is no established guideline-supported serotonin supplement for treating premature ejaculation.

Products marketed around serotonin may include ingredients such as:

• 5-HTP
• Tryptophan
• Herbal combinations
• Vitamins or minerals.

These are not equivalent to prescription SSRIs.

The fact that serotonin participates in ejaculation control does not mean taking a supplement advertised as “boosting serotonin” will reproduce the clinical effect of dapoxetine, paroxetine or sertraline.

Does 5-HTP Help Premature Ejaculation?

There is not enough high-quality clinical evidence to recommend 5-hydroxytryptophan (5-HTP) as a treatment for PE.

5-HTP is involved biologically in serotonin production, but increasing availability of a serotonin precursor is not the same as selectively modifying serotonin reuptake within the neurological pathways controlling ejaculation.

Current major PE treatment guidelines do not list 5-HTP as an established treatment.

Can Serotonin Supplements Be Combined With SSRIs?

Do not combine supplements intended to alter serotonin with an SSRI without discussing them with a doctor or pharmacist.

Food supplements can interact with prescription medicines, and products affecting serotonergic pathways can potentially increase adverse effects.

Always tell the clinician about:

• Vitamins
• Herbal medicines
• 5-HTP
• Tryptophan supplements
• Other non-prescription products

before starting an SSRI.

Can You Increase Serotonin Naturally to Treat PE?

There is no proven lifestyle method of increasing serotonin that has been shown to reliably treat premature ejaculation.

Healthy behaviours such as:

• Regular exercise
• Adequate sleep
• Stress management
• Balanced nutrition

can support general physical and psychological health.

They may also improve factors such as anxiety or cardiovascular health that can influence sexual function.

However, they should not be promoted as a specific serotonin-based cure for PE.

Does Diet Increase Serotonin Enough to Delay Ejaculation?

No specific food or dietary plan has been proven to produce a clinically meaningful delay in ejaculation by increasing serotonin.

Serotonin regulation in the nervous system is considerably more complex than simply eating foods containing tryptophan.

A healthy diet remains worthwhile for general health but should not replace evidence-based PE assessment or treatment.

Should You Take an Antidepressant Just to Last Longer?

Not without clinical assessment.

SSRIs are prescription medicines with real benefits and risks.

Using them without appropriate supervision can create problems involving:

• Drug interactions
• Excessive ejaculation delay
• Mood changes
• Withdrawal symptoms
• Gastrointestinal side effects
• Dizziness
• Erectile difficulties.

A clinician should first confirm that PE is actually present and determine whether medication is appropriate.

How Is Premature Ejaculation Diagnosed?

There is no serotonin test that confirms PE.

Clinical assessment typically considers:

• Ejaculation timing
• Perceived ability to delay ejaculation
• How consistently the pattern occurs
• Whether symptoms are lifelong or acquired
• Personal distress
• Relationship impact.

A doctor may also review:

• Erection quality
• Medicines
• Mental wellbeing
• Thyroid symptoms
• Prostate or urinary symptoms
• Other health conditions
• Possible mental disorders.

Do You Need Blood Tests Before an SSRI for PE?

Not routinely simply because PE is present.

Tests are generally guided by suspected underlying conditions.

For example, a clinician might consider further investigation when acquired PE occurs with symptoms suggesting:

• Thyroid disease
• Diabetes
• Another endocrine disorder
• Infection or inflammation.

A routine serotonin level is not normally part of PE diagnosis.

When Should You See a Doctor About PE?

Consider seeking medical advice if PE:

• Occurs persistently
• Is difficult to control
• Causes significant distress
• Affects a relationship
• Appears suddenly after previously normal control
• Occurs alongside erectile difficulties
• Occurs with urinary or prostate symptoms.

A GP or appropriately qualified clinician can assess whether medication such as dapoxetine is appropriate or whether another cause should be investigated first.

Serotonin and Premature Ejaculation: Key Takeaway

Serotonin is one of the most important neurotransmitters involved in ejaculation control, but premature ejaculation should not be reduced to a simple “low serotonin” disorder.

Serotonin generally has an inhibitory effect on ejaculation, helping increase the threshold required for the ejaculation reflex to occur.

Researchers have therefore proposed that reduced serotonergic signalling or altered serotonin-receptor sensitivity may contribute to lifelong premature ejaculation in some men.

However, there is no routine blood serotonin threshold that diagnoses PE.

A person can have premature ejaculation without having a clinically measurable “serotonin deficiency”, and PE can also be influenced by how consistently symptoms occur across different settings of sexual activity, as well as by:

• Anxiety
• Erectile dysfunction
• Prostate problems
• Thyroid disorders
• Relationship factors
• Other medical or psychological changes

SSRIs use the serotonergic pathway therapeutically.

By blocking serotonin reuptake, they increase serotonergic signalling and can strengthen inhibition of the ejaculation reflex.

Ejaculation itself depends on coordinated nerve signalling to the reproductive organs and movement of seminal fluid through the urethral pathway.

Evidence from thousands of men in randomised studies shows that SSRIs can improve ejaculation control, PE symptoms and treatment satisfaction, although they can also increase adverse effects.

Improving timing alone is not the only goal; treatment should also support sexual satisfaction.

In the UK, dapoxetine is the main short-acting SSRI specifically licensed for premature ejaculation. It is normally taken on demand rather than every day.

Conventional SSRIs such as paroxetine, sertraline and fluoxetine can also delay ejaculation but are primarily antidepressants, and their use specifically for PE is generally off-label.

By contrast, medicines such as alpha blockers can contribute to retrograde ejaculation, which is a different ejaculation disorder and not the same as PE.

For anyone searching “serotonin premature ejaculation,” “does low serotonin cause premature ejaculation,” “selective serotonin reuptake inhibitors for premature ejaculation” or “serotonin supplements for premature ejaculation,” the most accurate conclusion is:

Serotonin signalling influences ejaculation and provides the biological basis for SSRI treatment, but PE is not simply caused by having low serotonin. Clinically tested medicines can modify serotonin pathways and improve ejaculation control, while serotonin supplements have not been established as effective PE treatments.

Medical Disclaimer

This article explains the relationship between serotonin signalling, SSRIs and premature ejaculation for general educational purposes. It is not a recommendation to start an antidepressant, dapoxetine, 5-HTP or another serotonin-related product without assessment. Medicines that alter serotonin can cause side effects, withdrawal problems and clinically important interactions, and the appropriate PE treatment depends on whether symptoms are lifelong or acquired and whether other conditions are contributing. Speak with a GP, pharmacist or appropriately qualified prescriber before starting, stopping or combining serotonergic medicines or supplements.