Major
Established
Descripción
Combining two SSRIs is generally contraindicated due to markedly elevated serotonin syndrome risk and no additional therapeutic benefit.
Mecanismo
Both agents inhibit SERT-mediated serotonin reuptake; concurrent use produces additive serotonin accumulation in central synapses.
Relevancia clínica
Dual SSRI therapy provides no clinical advantage over monotherapy and substantially raises serotonin toxicity risk.
Manejo clínico
Avoid concurrent use; when switching SSRIs, allow an appropriate washout period (5 half-lives of the discontinued drug).