Serotonin syndrome is most likely to occur when SSRIs are prescribed alongside which class of medications?

Serotonin syndrome is a potentially life-threatening condition that arises from an excess of serotonin in the central nervous system. It can occur when certain medications that increase serotonin levels are combined. Selective serotonin reuptake inhibitors (SSRIs) work by increasing serotonin levels in the brain.

The most significant risk of serotonin syndrome occurs when SSRIs are taken concurrently with monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs). MAOIs inhibit the enzyme monoamine oxidase, which is responsible for breaking down neurotransmitters such as serotonin. When an SSRI is combined with an MAOI, the resultant increase in serotonin levels can lead to an excessive accumulation of serotonin, triggering serotonin syndrome. Similarly, TCAs also affect serotonin levels and can similarly contribute to this risk when combined with SSRIs.

This combination poses a greater risk as both classes of medications have the potential to raise serotonin levels significantly, increasing the likelihood of experiencing the symptoms associated with serotonin syndrome, such as agitation, confusion, rapid heart rate, and muscle rigidity.

Other classes of medications listed do not carry the same level of risk for inducing serotonin syndrome when used with SSRIs, making the combination of SSRIs with MAOIs or TCAs