STOP — Contraindicated
🔴 STOP — Contraindicated. Do not take St. Johns Wort with Paroxetine. This combination can cause serious harm or death.
Evidence level: STRONG
Combining St. John's Wort with Paxil is dangerous due to excessive serotonin activity.
Additive serotonergic effects via dual reuptake inhibition → Serotonin Syndrome.
Do NOT take St. Johns Wort and Paroxetine together under any circumstances. If you are currently taking both, contact your doctor or pharmacist immediately — do not stop either medication abruptly without medical guidance.
Take Paroxetine at the same time each day as prescribed. St. Johns Wort can be taken at any convenient time — morning with breakfast is most common. Some botanicals (St. John's Wort especially) have serotonergic activity and must NOT be combined with SSRIs. If you notice increased drowsiness or agitation, shift the botanical to a different time or discuss discontinuation with your prescriber.
Risk increases with higher doses of either substance, older age, liver or kidney impairment, and concurrent use of other serotonergic or CNS-depressant substances.
Agitation, confusion, rapid heartbeat, high blood pressure, dilated pupils, muscle twitching, diarrhea, high body temperature, seizures. Seek emergency care immediately.
Show this page to your doctor. Ask: "I want to take St. Johns Wort but I'm on Paroxetine. What safe alternatives do I have?"
Consider talking to your doctor about adjusting your antidepressant dose rather than adding St. Johns Wort. Safer supplement options for mood support include magnesium glycinate, omega-3 fish oil, or vitamin D3 — all with strong evidence and minimal drug interactions.
Combining St. John's Wort with Paxil is dangerous due to excessive serotonin activity.
Take Paroxetine at the same time each day as prescribed. St. Johns Wort can be taken at any convenient time — morning with breakfast is most common. Some botanicals (St. John's Wort especially) have serotonergic activity and must NOT be combined with SSRIs. If you notice increased drowsiness or agitation, shift the botanical to a different time or discuss discontinuation with your prescriber.
Agitation, confusion, rapid heartbeat, high blood pressure, dilated pupils, muscle twitching, diarrhea, high body temperature, seizures. Seek emergency care immediately.
Consider talking to your doctor about adjusting your antidepressant dose rather than adding St. Johns Wort. Safer supplement options for mood support include magnesium glycinate, omega-3 fish oil, or vitamin D3 — all with strong evidence and minimal drug interactions.
Show this page to your doctor. Ask: "I want to take St. Johns Wort but I'm on Paroxetine. What safe alternatives do I have?"
Or browse the full interaction database (121,000+ pairs).