We recently encountered 3 patients who had developed reversible paroxetine-associated hepatotoxicity. Two of the patients were over 80 years old and their hepatitis was accompanied by hyponatremia. In the third case, hepatitis was associated with multiple organ failure and the co-administration of trazodone. Here, we will discuss the possible role of preexisting risk factors in the development of paroxetine hepatotoxicity and review the relevant literature.