Moderate
Probable
Descripción
Concurrent fluoxetine and lithium may increase serotonin syndrome risk; fluoxetine may also alter lithium pharmacokinetics in some patients.
Mecanismo
Lithium potentiates serotonin release; fluoxetine inhibits SERT-mediated reuptake, leading to additive serotonergic stimulation.
Relevancia clínica
Clinical case series describe serotonin syndrome with this combination; the interaction is also used therapeutically under supervision.
Manejo clínico
Monitor lithium levels and watch for serotonin toxicity symptoms; consider dose reduction if signs emerge.