Drug interactions
Molindone + Paroxetine
Severity: Moderate
Molindone 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 an SSRI with an antipsychotic such as molindone can add serotonergic and dopamine-blocking effects. This may rarely precipitate serotonin syndrome or neuroleptic malignant syndrome. Paroxetine may also raise molindone exposure through CYP2D6 inhibition, increasing adverse effects such as extrapyramidal symptoms and sedation.
What this interaction means in plain words
Molindone 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.
Why it happens
Additive serotonergic and dopaminergic effects, plus possible CYP2D6 inhibition by paroxetine reducing molindone clearance.
What to do
Monitor for mental status change, hyperthermia, rigidity, autonomic instability and extrapyramidal symptoms, especially at initiation or dose change. Use the lowest effective molindone dose and reduce it if adverse effects emerge.
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
Frequently asked questions
Can I take Molindone with Paroxetine?
MediHelp rates the interaction as moderate. Molindone 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 an SSRI with an antipsychotic such as molindone can add serotonergic and dopamine-blocking effects. This may rarely precipitate serotonin syndrome or neuroleptic malignant syndrome. Paroxetine may also raise molindone exposure through CYP2D6 inhibition, increasing adverse effects such as extrapyramidal symptoms and sedation.
How serious is the interaction between Molindone 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 mental status change, hyperthermia, rigidity, autonomic instability and extrapyramidal symptoms, especially at initiation or dose change. Use the lowest effective molindone dose and reduce it if adverse effects emerge.
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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