There is a drug-drug interaction between paroxetine and dextromethorphan which can result in excess serotonin release, and possibly a condition called serotonin syndrome. The symptoms of serotonin syndrome include confusion, fever, hallucinations, shaking, sweating, and possibly even coma. So it is important that you read the labels of cough and cold medications in order to see if dextromethorphan is an ingredient on the label if you’re taking paroxetine. One way to clue you into this is dextromethorphan is often listed as DM on the label. Dextromethorphan generally should be avoided by patients on any of the SSRI anti-depressants. And if needed, use only the under the advisement of your doctor.