MajorSNRI×Selective serotonin reuptake inhibitors (SSRIs)
Updated · Methodology
Mechanism
SSRI + SNRI – serotonergic load rises, serotonin syndrome risk. The combination has no therapeutic rationale.
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia. Autonomic features: sweating, tachycardia, hypertension, fever. First signs appear within hours of co-administration.
Management
The combination is not prescribed. When switching antidepressants, allow a 1-week washout. For augmentation, use mirtazapine or agomelatine.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
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Sources
- FDA: Cymbalta section 7 (2017)– ; DailyMed setid 2f7d4d67-10c1-4bf4-a7f2-c185fbad64ba