Drug & supplement interaction

Ashwagandha + Paroxetine

Paroxetine brand names: Paxil CR, Paxil, Brisdelle.

Minor Interaction
Medically reviewed by · Updated August 2024
The bottom line Minor

Ashwagandha has a minor interaction with Paroxetine. Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ashwagandha and Paroxetine

Here is the interaction we found between these two, with the evidence behind it.

Minor

Serotonergic Drugs

Why this applies to Paroxetine

Paroxetine falls under Serotonergic Drugs — the group Ashwagandha interacts with.

Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors. However, there is no evidence to suggest that ashwagandha increases the risk of serotonin-related effects, and there have been no published case reports of serotonin syndrome when combined with other serotonergic drugs. Nevertheless, due to the lack of extensive studies on the matter and the fact that ashwagandha appears to affect serotonergic pathways, it would be prudent to exercise caution when combining it with drugs that affect serotonin. [References: - Effects of Withania somnifera (Ashwaga ndha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021 Sep 14; 19: 1468–1495. - A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/]
Severity Minor Likelihood Possible Evidence C

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

If you take paroxetine (Paxil) and you're curious about adding ashwagandha, here's the honest picture. Paroxetine works by raising serotonin levels in your brain, and a handful of animal studies hint that ashwagandha may nudge serotonin pathways too. In theory, stacking two things that touch serotonin could add up.

That said, this is a minor, mostly theoretical concern. There are no human case reports of problems when ashwagandha is combined with serotonin drugs like paroxetine, so I wouldn't lose sleep over it. Still, it's smart to know the warning signs of too much serotonin: agitation, a racing heart, shivering, sweating, or muscle twitching. If anything like that shows up, reach out right away. Before starting ashwagandha, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ashwagandha Also Interacts With Other Medications

Ashwagandha has 916 moderate, 455 minor known drug interactions in our database — the Paroxetine one above is one of them. If you take anything else, check it against the full list below.

Moderate 916 Minor 455 No known interaction 1,459 (incl. Paroxetine)
Taking anything else?

Check Another of Your Medications Against Ashwagandha

Covers the 2,830 medications we’ve checked against Ashwagandha. Pick one to open its full report.

From our Q&A

Questions About Ashwagandha or Paroxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ashwagandha or Paroxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Paroxetine

This page covers Ashwagandha only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paroxetine page lists 134 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Iboga (major), Lithium (major), 1,3-dmaa (moderate) and 5-htp (moderate).

By severity: 3 major · 105 moderate · 26 minor.

From our pharmacist’s overview on the Paroxetine page

“I treat paroxetine (Paxil, Paxil CR, Brisdelle) as a medication where supplement choices genuinely matter, not one to wave through. This antidepressant raises serotonin, so about twenty of the ingredients listed here, lithium among them, can push serotonin too high and risk serotonin syndrome, a dangerous reaction.”

Reviewed by 2 · Jul 18, 2026

Open the Paroxetine interaction page

One more smart check

Taking Ashwagandha as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,964 real supplement products containing Ashwagandha, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ashwagandha. Your product may carry other ingredients that interact with Paroxetine too, on top of Ashwagandha — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ashwagandha and Paroxetine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ashwagandha
Top 5%

#30 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Paroxetine
Top half

#1,189 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ashwagandha

What is Ashwagandha?

Ashwagandha
  • Stress and anxiety
  • Sleep problems
  • Fatigue and low energy
  • Athletic performance
  • General well-being (adaptogen)

Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally well tolerated for short-term use in healthy adults, but it should be avoided in pregnancy and used cautiously by people with thyroid or liver problems. Talk with your pharmacist or doctor before starting it.

Read the full Ashwagandha monograph & all interactions
Medication

About Paroxetine

What Is Paroxetine Used For?

Brand names: Paxil CR, Paxil, Brisdelle

Paroxetine tablets, film-coated tablets, and oral suspensions are approved in adults for major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). The extended-release tablet forms (Paxil CR, paroxetine HCL CR, and paroxetine extended-release tablets) are approved in adults for MDD, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

Brisdelle (paroxetine 7.5 mg capsule) and generic paroxetine capsules are approved specifically for moderate to severe vasomotor symptoms (hot flashes) associated with menopause — not for any psychiatric condition. Paroxetine tablets are not approved for use in children.

See full Paroxetine drug information
Keep checking

Other Drugs & Ashwagandha

Browse every other medication we’ve checked against Ashwagandha — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
916Moderate
455Minor
1,458No known interaction
916 Moderate 455 Minor 1,458 No interaction
Moderate

916 interactions

Showing 60 of 916 moderate interactions — see all 916 on the Ashwagandha page.

Minor

455 interactions

Showing 60 of 455 minor interactions — see all 455 on the Ashwagandha page.

No interaction 1,458 drugs checked — show the list

We also checked Ashwagandha against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,458 medications checked with no known interaction — see the full Ashwagandha list.

See the full Ashwagandha interactions page
See every supplement checked against Paroxetine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Ashwagandha monograph › Uses, safety, and every drug interaction in one place Paroxetine supplement interactions › Every supplement checked against Paroxetine, ranked by severity Paroxetine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ashwagandha and Paroxetine Together: Common Questions

Can you take Ashwagandha with Paroxetine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ashwagandha and Paroxetine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Paroxetine and Ashwagandha?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.