sertraline + paroxetine + venlafaxine

This is a combination of three antidepressant medications—sertraline, paroxetine, and venlafaxine. Sertraline and paroxetine are selective serotonin reuptake inhibitors (SSRIs), while venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI). All three drugs act primarily by increasing the levels of serotonin in the brain, with venlafaxine also increasing norepinephrine. These agents are individually approved for major depressive disorder and other psychiatric conditions such as anxiety disorders and post-traumatic stress disorder (PTSD)[1][2][7]. The combination of multiple antidepressants is sometimes considered in treatment-resistant depression but carries an increased risk of adverse effects, including serotonin syndrome[3][4][5]. There is limited evidence supporting the simultaneous use of all three together; most clinical experience involves combining one SSRI with an SNRI or other agent when monotherapy fails[3][4][5].