Drug & supplement interaction

Iboga + Paroxetine

Paroxetine brand names: Paxil CR, Paxil, Brisdelle.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Paroxetine falls into 3 drug categories that Iboga can interact with; the most serious is rated major. Theoretically, taking paroxetine with iboga might increase the levels and clinical effects of ibogaine.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Iboga and Paroxetine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Iboga interacts with whole categories of medication. Paroxetine falls into 3 of those categories, so it can interact with Iboga in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

PAROXETINE (PAXIL)

1 of 3
Theoretically, taking paroxetine with iboga might increase the levels and clinical effects of ibogaine.
One pharmacokinetic study shows that taking paroxetine prior to taking ibogaine, a constituent of iboga, 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with taking ibogaine alone. This is thought to be due to inhibition of cytochrome P450 2D6 by paroxetine. Additionally, ibogaine has serotonergic effects and may increase the risk for serotonergic adverse effects when taken with paroxetine.
Severity Major Likelihood Probable Evidence B

Interaction 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..

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

Here's the short version for Paxil and Iboga: this is one combination I'd steer you away from. Paroxetine blocks a liver enzyme called CYP2D6, which is the same enzyme your body uses to clear ibogaine (the active compound in Iboga). One small study found that taking paroxetine first roughly doubled the amount of ibogaine and its breakdown product in the body. More ibogaine hanging around means a higher chance of its most dangerous effect, serious heart rhythm changes.

On top of that, both raise serotonin, so you also risk serotonin syndrome (agitation, sweating, fast heartbeat, shaking, confusion). Keep in mind ibogaine is illegal in the U.S. and genuinely risky on its own. Please don't change your paroxetine, but do talk with your doctor or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Glick SD, Maisonneuve IS. Mechanisms of antiaddictive actions of ibogaine. Ann N Y Acad Sci 1998;844:214-26.
  2. Glue P, Winter H, Garbe K, et al. Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20?mg dose of ibogaine in healthy volunteers. J Clin Pharmacol. 2015;55(6):680-7. PubMed
  3. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
Moderate

SEROTONERGIC DRUGS

2 of 3

Why this applies to Paroxetine

Paroxetine falls under SEROTONERGIC DRUGS — the group Iboga interacts with.

Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.
Ibogaine, a constituent in iboga, has serotonergic effects. Theoretically, combining serotonergic drugs with iboga might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using iboga with serotonergic drugs.
Severity Moderate Likelihood Possible Evidence D

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

Here's the concern with this pairing. Paroxetine (Paxil) is an SSRI, meaning it raises serotonin levels in your brain to ease depression and anxiety. Iboga, through its compound ibogaine, also pushes serotonin activity. Stack the two together and you can get too much serotonin at once, which is the worry here.

When serotonin climbs too high, you can run into what we call serotonin syndrome. That can look like agitation, a racing heart, sweating, shivering, muscle twitching, confusion, and in serious cases it becomes a medical emergency. Keep in mind this caution is theoretical, based on how both substances work rather than proven cases. Still, ibogaine carries real heart and safety risks on its own, so please talk with your doctor or pharmacist before combining anything with your paroxetine.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Glick SD, Maisonneuve IS. Mechanisms of antiaddictive actions of ibogaine. Ann N Y Acad Sci 1998;844:214-26.
  2. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
  3. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS

3 of 3

Paroxetine also falls under CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS.

Theoretically, taking iboga with CYP2D6 inhibitors might increase the levels and clinical effects of ibogaine.
Ibogaine, the active constituent of iboga, is a substrate of CYP2D6. One pharmacokinetic study shows that taking the CYP2D6 inhibitor paroxetine prior to taking ibogaine 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with ibogaine alone.
Severity Moderate Likelihood Possible Evidence B

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

Here's the key thing to understand: in this pairing, it's the Iboga that gets affected, not your Paxil. Paroxetine is a strong blocker of a liver enzyme called CYP2D6, and that same enzyme is what your body uses to break down ibogaine, the active compound in Iboga. When paroxetine slows that breakdown, ibogaine and its byproduct can pile up. In one study, levels roughly doubled compared to taking Iboga alone.

Why that matters: ibogaine is already risky on its own and can trigger dangerous heart rhythm problems. Higher levels make that more likely. On top of that, mixing it with an SSRI like paroxetine raises serotonin concerns. I really can't recommend Iboga at all, but if it's on your mind, please talk it through with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Henstra M, Wong L, Chahbouni A, et al. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine. Clin Toxicol (Phila). 2017;55(6):600-602. PubMed
  2. Glue P, Winter H, Garbe K, et al. Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20?mg dose of ibogaine in healthy volunteers. J Clin Pharmacol. 2015;55(6):680-7. PubMed
  3. Rodriguez P, Urbanavicius J, Prieto JP, et al. A single administration of the atypical psychedelic ibogaine or its metabolite noribogaine induces an antidepressant-like effect in rats. ACS Chem Neurosci 2020;11(11):1661-1672. PubMed

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

Iboga Also Interacts With Other Medications

Iboga has 501 moderate known drug interactions in our database — the Paroxetine one above is among them. If you take anything else, check it against the full list below.

Moderate 501 No known interaction 2,329 (incl. Paroxetine)
Taking anything else?

Check Another of Your Medications Against Iboga

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

From our Q&A

Questions About Iboga 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 Iboga 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 Iboga 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), Lithium (major), 1,3-dmaa (moderate), 5-htp (moderate) and Acacia Rigidula (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

How much people look this up

Where Iboga 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 Iboga
Top half

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

29 days ago today
Medication Paroxetine
Top half

#1,107 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 Iboga

What is Iboga?

Iboga
  • Drug and alcohol addiction
  • Opioid withdrawal
  • Spiritual and ceremonial rituals
  • Fatigue and stimulant effects
  • Mood and emotional issues

Iboga is a Central African shrub whose root bark contains ibogaine, a powerful hallucinogenic compound studied mainly for addiction. It carries serious safety risks, including dangerous heart rhythm changes and deaths, and ibogaine is illegal in the United States and many other countries. We do not recommend its use outside of tightly controlled research settings.

Read the full Iboga 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 & Iboga

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

0Major
501Moderate
0Minor
2,328No known interaction
501 Moderate 2,328 No interaction
Moderate

501 interactions

Showing 60 of 501 moderate interactions — see all 501 on the Iboga page.

No interaction 2,328 drugs checked — show the list

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

Showing the 60 most looked-up of 2,328 medications checked with no known interaction — see the full Iboga list.

See the full Iboga 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
Iboga 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 Iboga and Paroxetine Together: Common Questions

Can you take Iboga with Paroxetine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Iboga and Paroxetine?
Paroxetine belongs to more than one drug category, and Iboga interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Iboga and Paroxetine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Paroxetine and Iboga?

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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.