Moderate
Probable
Descripción
Sertraline combined with trazodone may increase the risk of serotonin syndrome due to additive serotonergic effects.
Mecanismo
Sertraline inhibits SERT; trazodone inhibits serotonin reuptake and is a 5-HT2 receptor antagonist, producing combined serotonergic stimulation.
Relevancia clínica
Case reports of serotonin syndrome exist; the combination is sometimes used for treatment-resistant depression with insomnia under close monitoring.
Manejo clínico
Use at the lowest effective doses; monitor for signs of serotonin toxicity including agitation, tremor, and hyperthermia.