What the FDA labels say about taking them together
Lithium and paroxetine
Paroxetine's FDA label of February 12, 2026 names lithium in its drug interactions section; lithium's label does not name paroxetine itself but warns about its class (serotonin reuptake inhibitors). The paroxetine label: “The risk is increased with concomitant use of other serotonergic drugs and with drugs that impair metabolism of serotonin, i.e., MAOIs.”
Check it at the source: the lithium FDA label on DailyMed (effective December 23, 2025, Glenmark Pharmaceuticals Inc., USA); the paroxetine FDA label on DailyMed (effective February 12, 2026, Mylan Pharmaceuticals Inc.).
What does the lithium label say about paroxetine?
Lithium's label does not name paroxetine itself; it warns about its class (serotonin reuptake inhibitors):
Lithium label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, triptans, tricyclic antidepressants, fentanyl, tramadol, tryptophan, buspirone, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Drug Interactions ( 7.1 )].
Source: FDA drug label (Lithium Carbonate), Glenmark Pharmaceuticals Inc., USA, effective December 23, 2025 (SPL set 63b3790f-a9b5-47f4-bae1-ddf8b43c13c1), via openFDA; the full label on DailyMed
What does the paroxetine label say about lithium?
Paroxetine label, drug interactionsOther Serotonergic Drugs Clinical Impact The concomitant use of serotonergic drugs with paroxetine tablets increases the risk of serotonin syndrome. Intervention Monitor patients for signs and symptoms of serotonin syndrome, particularly during treatment initiation and dosage increases. If serotonin syndrome occurs, consider discontinuation of paroxetine tablets and/or concomitant serotonergic drugs [see Warnings and Precautions (5.2) ]. Examples other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort.
Paroxetine label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Contraindications (4), Drug Interactions (7.1) ].
Paroxetine Hydrochloride label (Apotex Corp, September 16, 2026), drug interactionsExamples Other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, St. John’s Wort Drugs that Interfere with Hemostasis (antiplatelet agents and anticoagulants) Clinical Impact The concurrent use of an antiplatelet agent or anticoagulant with Paroxetine HCL CR may potentiate the risk of bleeding. Intervention Inform patients of the increased risk of bleeding associated with the concomitant use of Paroxetine HCL CR and antiplatelet agents and anticoagulants. For patients taking warfarin, carefully monitor the international normalized ratio [see Warnings and Precautions ( 5.5 )].
Brisdelle label (Legacy Pharma USA, Inc., April 28, 2025), drug interactionsSerotonergic Drugs If concomitant use of BRISDELLE with other serotonergic drugs (e.g., other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort) is clinically warranted, consider the increased risk of serotonin syndrome and carefully observe the patient, particularly during treatment initiation [see Warnings and Precautions ( 5.2 )].
Paxil label (Apotex Corp, October 22, 2024), drug interactionsExamples; other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort.
Source: FDA drug label (Paroxetine Hydrochloride, NDA020936), Apotex Corp, effective September 16, 2026 (SPL set 087ff0d3-1761-47ea-a8c1-7c4cb679af97), via openFDA
Source: FDA drug label (Brisdelle, NDA204516), Legacy Pharma USA, Inc., effective April 28, 2025 (SPL set 502311b3-b617-4cbd-a3ab-a60f2c62880a), via openFDA
Source: FDA drug label (Paroxetine), Mylan Pharmaceuticals Inc., effective February 12, 2026 (SPL set 89dd7e24-85fc-4152-89ea-47ec2b48a1ed), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Lithium | Paroxetine | |
|---|---|---|
| Labeled for | Bipolar disorder | Depression, Anxiety, Menopause symptoms |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.104 per capsule 300 mg capsule | $0.0611 per tablet 20 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once