Major
Established
Descripción
Co-prescribing two SSRIs leads to additive serotonin excess with no therapeutic benefit and high risk of serotonin syndrome.
Mecanismo
Both escitalopram and sertraline inhibit the serotonin transporter (SERT); concurrent use causes additive blockade and serotonin accumulation.
Relevancia clínica
Combination offers no evidence-based advantage and increases serotonin toxicity risk significantly.
Manejo clínico
Contraindicated; switch fully from one SSRI to another with appropriate washout period rather than combining.