Drug & supplement interaction

Indian Snakeroot + Paroxetine

Paroxetine brand names: Paxil CR, Paxil, Brisdelle.

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

Indian Snakeroot has a moderate interaction with Paroxetine. Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.

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

Indian Snakeroot and Paroxetine

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Paroxetine

Paroxetine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Indian Snakeroot interacts with.

Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 gist for Paroxetine (Paxil): your liver uses an enzyme called CYP2D6 to clear it from your body. Lab studies suggest that Indian snakeroot, which contains a bit of yohimbine, might slow that same enzyme down. If that happens, paroxetine could clear more slowly and build up, which may bump up its usual side effects like drowsiness, nausea, dry mouth, dizziness, or trouble sleeping.

I want to be honest with you, though: this is only a theoretical concern based on test-tube research, not real patient cases, so it may not amount to much. The bigger worry is that snakeroot itself lowers blood pressure and can worsen mood, which doesn't mix well with an antidepressant. Please loop in your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. 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

Indian Snakeroot Also Interacts With Other Medications

Indian Snakeroot has 83 major, 759 moderate 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.

Major 83 Moderate 759 No known interaction 1,988 (incl. Paroxetine)
Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

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

From our Q&A

Questions About Indian Snakeroot 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 Indian Snakeroot 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 Indian Snakeroot 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 Indian Snakeroot as Part of a Dietary Supplement Product? Check It for Interactions

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Your product may carry other ingredients that interact with Paroxetine too, on top of Indian Snakeroot — 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 Indian Snakeroot 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 Indian Snakeroot
Top half

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

29 days ago today
Medication Paroxetine
Top half

#1,186 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 Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Read the full Indian Snakeroot 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 & Indian Snakeroot

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

83Major
759Moderate
0Minor
1,987No known interaction
83 Major 759 Moderate 1,987 No interaction
Major

83 interactions

Showing 60 of 83 major interactions — see all 83 on the Indian Snakeroot page.

Moderate

759 interactions

Showing 60 of 759 moderate interactions — see all 759 on the Indian Snakeroot page.

No interaction 1,987 drugs checked — show the list

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

Showing the 60 most looked-up of 1,987 medications checked with no known interaction — see the full Indian Snakeroot list.

See the full Indian Snakeroot 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
Indian Snakeroot 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 Indian Snakeroot and Paroxetine Together: Common Questions

Can you take Indian Snakeroot with Paroxetine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Indian Snakeroot and Paroxetine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Paroxetine and Indian Snakeroot?

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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.