NutriStack
Paroxetine and St. John's Wort, contraindicated.
Dual serotonin reuptake inhibition from paroxetine and St. John's Wort creates high serotonin syndrome risk.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Paroxetine and St. John's Wort
- Pair type
- Contraindicated
- Evidence (highest tier)
- Strong
- Source citations
- 1 source
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Strong evidence
Contraindicated
What is happening. Dual serotonin reuptake inhibition from paroxetine and St. John's Wort creates high serotonin syndrome risk.
Mechanism. Both paroxetine and hyperforin inhibit SERT. Combined SERT blockade causes excessive synaptic serotonin accumulation.
Recommendation. Do NOT combine. Allow at least 2 weeks washout after stopping paroxetine before starting SJW.
Stack Score
How this pair moves the number.
Effect on the composite score
If both Paroxetine and St. John's Wort are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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