Medication·Interactions & depletion·Reviewed June 9, 2026
Paroxetine interactions.
Paroxetine has 8 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Paroxetine at a glance.
A quick, data-grounded summary. The full tables are below.
Paroxetine has 8 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with paroxetine.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| 5-HTP | Contraindicated | 5-HTP combined with paroxetine creates dangerous serotonin syndrome risk. Paroxetine is the most potent SERT inhibitor among SSRIs. details → |
| L-Tryptophan | Contraindicated | L-Tryptophan is the upstream precursor to serotonin. Combined with paroxetine's potent serotonin reuptake blockade, supplemental L-tryptophan can... details → |
| MDMA | Contraindicated | Paroxetine blocks the serotonin transporter MDMA uses to release serotonin, and paroxetine is also a potent CYP2D6 inhibitor - the enzyme that... details → |
| St. John's Wort | Contraindicated | Dual serotonin reuptake inhibition from paroxetine and St. John's Wort creates high serotonin syndrome risk. |
| Fish Oil | Caution | Paroxetine depletes platelet serotonin stores and impairs aggregation; high-dose fish oil adds antiplatelet activity. Together they raise bleeding... details → |
| Ginkgo Biloba | Caution | Paroxetine depletes platelet serotonin and impairs aggregation; Ginkgo's ginkgolides inhibit platelet-activating factor. The combination compounds... details → |
| Rhodiola Rosea | Caution | Paroxetine is serotonergic. Rhodiola has preclinical monoamine and MAO-related findings, but direct human evidence for serotonin syndrome with... |
| SAMe | Caution | SAMe has independent serotonergic and antidepressant activity. Combined with paroxetine, the additive serotonergic effect raises the risk of... |
What paroxetine can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Sodium | Significant | SSRI-induced SIADH can lower serum sodium, especially in older adults and during the first weeks of therapy. | – | Serum sodium |
| Folate | Mild | Lower folate status is associated with poorer SSRI response and may be reduced in some chronic users through altered one-carbon metabolism. | Methylfolate | Serum folate or RBC folate |
The full paroxetine profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common paroxetine questions.
Quick answers drawn from the tables above.
What interacts with Paroxetine?
In the NutriStack database, Paroxetine has 8 documented interactions. The most notable include 5-HTP, L-Tryptophan, MDMA, St. John's Wort, and Fish Oil. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Paroxetine?
Paroxetine is flagged against 4 substances in the database, including 5-HTP, L-Tryptophan, MDMA, and St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Paroxetine deplete any nutrients?
Paroxetine is associated with lowering Sodium and Folate with prolonged use. Useful biomarkers to monitor include Serum sodium and Serum folate or RBC folate. Ask your prescriber before adding any replacement supplement.
Is it safe to take 5-HTP with Paroxetine?
NutriStack classifies the 5-HTP and Paroxetine pairing as contraindicated: 5-HTP combined with paroxetine creates dangerous serotonin syndrome risk. Paroxetine is the most potent SERT inhibitor among SSRIs. Do NOT take 5-HTP with paroxetine. Always confirm with your prescriber.
Check your whole stack
See how paroxetine fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.