fluoxetine + paroxetine + fluvoxamine + sertraline + citalopram + escitalopram

This is a combination of six selective serotonin reuptake inhibitors (SSRIs): fluoxetine, paroxetine, fluvoxamine, sertraline, citalopram, and escitalopram. Each of these drugs is an approved antidepressant used primarily for the treatment of major depressive disorder and various anxiety disorders. They act by selectively inhibiting the reuptake of serotonin (5-HT) in the central nervous system, thereby increasing synaptic serotonin levels and enhancing serotonergic neurotransmission. These medications are generally considered first-line pharmacological treatments for depression due to their efficacy and relatively favorable side effect profiles compared to older antidepressants such as tricyclics or monoamine oxidase inhibitors[4][7][9][10]. Combining multiple SSRIs is not standard clinical practice due to a high risk of adverse effects—including potentially life-threatening serotonin syndrome—and significant drug-drug interactions[1].