Drug interactions
Paroxetine + Risperidone
Severity: Moderate
Paroxetine and Risperidone: 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
Paroxetine strongly inhibits CYP2D6, which converts risperidone to 9-hydroxyrisperidone, so risperidone levels rise and adverse effects such as extrapyramidal symptoms, sedation and hypotension may increase. The active moiety changes less than the parent drug, but dose-related effects can still emerge. Additive QT effects and rare serotonin syndrome or NMS are also possible.
What this interaction means in plain words
Paroxetine and Risperidone 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.
Paroxetine belongs to Central Nervous System; Risperidone belongs to Central Nervous System.
Why it happens
Paroxetine inhibits CYP2D6-mediated metabolism of risperidone, with additive QT and serotonergic/dopaminergic pharmacodynamic effects.
What to do
Start risperidone at a low dose and titrate to response, monitoring for extrapyramidal symptoms and sedation. Reduce the risperidone dose if adverse effects appear, and reassess it when paroxetine is stopped.
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 Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
Frequently asked questions
Can I take Paroxetine with Risperidone?
MediHelp rates the interaction as moderate. Paroxetine and Risperidone 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. Paroxetine strongly inhibits CYP2D6, which converts risperidone to 9-hydroxyrisperidone, so risperidone levels rise and adverse effects such as extrapyramidal symptoms, sedation and hypotension may increase. The active moiety changes less than the parent drug, but dose-related effects can still emerge. Additive QT effects and rare serotonin syndrome or NMS are also possible.
How serious is the interaction between Paroxetine and Risperidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start risperidone at a low dose and titrate to response, monitoring for extrapyramidal symptoms and sedation. Reduce the risperidone dose if adverse effects appear, and reassess it when paroxetine is stopped.
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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