ModerateSelective serotonin reuptake inhibitors (SSRIs)×Selective 5-HT1B/1D serotonin receptor agonist
Updated · Methodology
Mechanism
Theoretical serotonin syndrome risk with SSRI + triptan. FDA revised the recommendation in 2018 (previously CONTRA) – clinical cases at standard doses are few. Still, monitoring is needed at first use.
Symptoms
Rarely – agitation, tremor, myoclonus. Mainly with high triptan doses or SNRI combination.
Management
The AEMPS label for sertraline describes rare postmarketing cases of weakness, hyperreflexia and confusion, without banning the pair. Acceptable at standard doses. Inform patient of possible symptoms.
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: FDA Drug Safety Communication on citalopram QT prolongation (2012)
- AEMPS: Ficha técnica: Sertralina (nº registro 66057), sección 4.5 (2025)– AEMPS, CIMA, nº registro 66057, sección 4.5