This case illustrates the development of serotonin syndrome as a result of the interaction between escitalopram and Withania somnifera. As the rising prevalence of SSRI use is matched with a growing interest in ashwagandha’s potential as a viable, alternative natural remedy across numerous disease etiologies, it becomes clinically relevant to understand the potential interactions between widely used FDA-approved pharmaceuticals and less-regulated natural supplements. Recognition of serotonin syndrome as a possible side effect of this interaction is critical to the prompt institution of appropriate therapy and prevention of a fatal progression.