Major
Paroxetine × Risperidone
Selective serotonin reuptake inhibitor (SSRI)×Atypical antipsychotic – dopamine and serotonin receptor antagonist
Mechanism
Paroxetine is a strong CYP2D6 inhibitor. Risperidone rises 4-fold – enhanced hyperprolactinaemia and sedation.
Symptoms
Sedation, extrapyramidal symptoms, hyperprolactinaemia.
Management
Reduce risperidone by 50%. Alternative SSRI – sertraline or escitalopram (no CYP2D6 inhibition).
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.