Moderate
Probable
Mô tả
Escitalopram combined with lithium may augment serotonergic neurotransmission, increasing the risk of serotonin syndrome particularly at higher doses.
Cơ chế
Lithium enhances presynaptic serotonin synthesis and release; escitalopram blocks serotonin reuptake, resulting in additive serotonergic excess.
Ý nghĩa lâm sàng
The combination is sometimes used therapeutically for treatment-resistant depression, but serotonin syndrome cases have been reported.
Xử trí
Initiate at low doses and titrate gradually; monitor closely for tremor, myoclonus, agitation, or fever indicative of serotonin toxicity.