Drug interactions
Lithium + Paroxetine
Severity: Moderate
Lithium and Paroxetine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining lithium with an SSRI may increase serotonergic effects, causing tremor, agitation or rarely serotonin syndrome. Neurotoxicity can also occur without elevated lithium levels.
What this interaction means in plain words
Lithium and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Lithium belongs to Central Nervous System; Paroxetine belongs to Central Nervous System.
Why it happens
Additive enhancement of serotonergic neurotransmission.
What to do
Monitor for tremor, confusion, hyperreflexia and other signs of serotonin toxicity, and check lithium levels periodically. Reduce doses or stop if toxicity appears.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Paroxetine?
MediHelp rates the interaction as moderate. Lithium and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Combining lithium with an SSRI may increase serotonergic effects, causing tremor, agitation or rarely serotonin syndrome. Neurotoxicity can also occur without elevated lithium levels.
How serious is the interaction between Lithium and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tremor, confusion, hyperreflexia and other signs of serotonin toxicity, and check lithium levels periodically. Reduce doses or stop if toxicity appears.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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