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