MajorSelective serotonin reuptake inhibitors (SSRIs)×Selective serotonin reuptake inhibitors (SSRIs)
Updated · Methodology
Mechanism
Sertraline belongs to the same class. Its SmPC states outright that the risk of serotonin syndrome and neuroleptic malignant syndrome rises with concomitant serotonergic drugs, other antidepressants included. Post-marketing reports also describe QTc prolongation with torsade, mostly in patients with other risk factors.
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia, sweating, diarrhoea, tachycardia, and in severe cases hyperthermia and rigidity. Symptoms usually appear within a day of adding the second drug or raising the dose. In patients with cardiac risk factors QTc is tracked separately.
Management
Two SSRIs together add no effect while their risks stack. Most often the pair is the trace of an unfinished switch, and one drug stays in the regimen.
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Lexapro (escitalopram) prescribing information (2023)– FDA label, Allergan, Inc., DailyMed setid 13bb8267-1cab-43e5-acae-55a4d957630a, revised 10/2023, sections 4, 5.2 and 7
- AEMPS: Ficha técnica de Cipralex 10 mg (escitalopram) (2026)– AEMPS CIMA, nregistro 65230, revisión 03/2026, secciones 4.3 y 4.5
- AEMPS: Ficha técnica de Besitran 20 mg/ml (sertralina) (2025)– AEMPS CIMA, nregistro 63477, revisión 08/2025, secciones 4.4 y 4.5