sertraline + fluvoxamine

Sertraline + fluvoxamine is a combination of two selective serotonin reuptake inhibitors (SSRIs), sertraline and fluvoxamine. Both drugs act primarily by inhibiting the reuptake of serotonin (5-HT) in the central nervous system, thereby increasing synaptic serotonin levels and improving mood and anxiety symptoms. Sertraline is commonly used for depression, various anxiety disorders, and obsessive-compulsive disorder (OCD). Fluvoxamine is mainly indicated for OCD but also used off-label for depression and other anxiety disorders. The combination has been studied in treatment-resistant cases of OCD to assess whether dual SSRI therapy offers superior efficacy compared to monotherapy or other combinations[2]. Both agents have distinct pharmacokinetic profiles; notably, fluvoxamine inhibits CYP2C19, which can affect sertraline metabolism[6]. Combining these medications increases the risk of additive side effects such as central nervous system depression, impairment of judgment or psychomotor skills, and potentially serious adverse reactions like serotonin syndrome[4].