Editing Paroxetine (section)

== Interactions ==

Interactions with other drugs acting on the serotonin system or impairing the metabolism of serotonin may increase the risk of [[serotonin syndrome]] or [[neuroleptic malignant syndrome]] (NMS)-like reaction. Such reactions have been observed with SNRIs and SSRIs alone, but particularly with concurrent use of [[triptan]]s, [[Monoamine oxidase inhibitor|MAO inhibitors]], antipsychotics, or other dopamine antagonists.

The prescribing information states that paroxetine should "not be used in combination with an [[Monoamine oxidase inhibitor|MAOI]] (including linezolid, an antibiotic which is a reversible non-selective MAOI), or within 14 days of discontinuing treatment with an MAOI", and should not be used in combination with [[pimozide]], [[thioridazine]], [[tryptophan]], or [[warfarin]].<ref name="gsk-paxil"/>

Paroxetine interacts with the following [[cytochrome P450]] enzymes:<ref name = PhDep>{{cite book|title=Pharmacotherapy of Depression |year=2011 |doi=10.1007/978-1-60327-435-7 |publisher=Humana Press |isbn=978-1-60327-434-0 |edition=2nd |location=New York, NY |veditors=Ciraulo DA, Shader RI}}</ref><ref name="ReferenceA">{{cite journal | vauthors = Sanchez C, Reines EH, Montgomery SA | title = A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike? | journal = International Clinical Psychopharmacology | volume = 29 | issue = 4 | pages = 185–196 | date = July 2014 | pmid = 24424469 | pmc = 4047306 | doi = 10.1097/YIC.0000000000000023 }}</ref>
* [[CYP2D6]] for which it is both a [[Substrate (biochemistry)|substrate]] and a potent inhibitor.<ref name = TGA/><ref name="PhDep"/>
* [[CYP2B6]] (''strong'') inhibitor.
* [[CYP3A4]] (''weak'') inhibitor.
* [[CYP1A2]] (''weak'') inhibitor.
* [[CYP2C9]] (''weak'') inhibitor.
* [[CYP2C19]] (''weak'') inhibitor.

Paroxetine has been shown to be an inhibitor of [[G protein-coupled receptor kinase 2]] (GRK2).<ref name=":0" /><ref name=":1" />