Is St. John's Wort Safe with paroxetine?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid combining St. John's Wort with paroxetine. Monitor for signs of serotonin syndrome such as agitation, hallucinations, rapid heart rate, fever, muscle twitching, or nausea. If symptoms occur, discontinue use and contact your healthcare provider immediately.
Why this interaction occurs
St. John's Wort is listed as a serotonergic drug whose concomitant use with paroxetine increases the risk of serotonin syndrome, particularly during treatment initiation and dosage increases.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 53,308 reports mentioning paroxetine. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the paroxetine + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All St. John's Wort interactions → · All paroxetine interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.