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Selective serotonin reuptake inhibitors interact with other drugs mainly as a result of its inhibitory activity on hepatic cytochrome P450 isoenzymes. Individual SSRIs do not all exhibit the same degree of inhibition nor react with the isoenzymes. The drugs inhibited by specific SSRIs depend on the isoenzyme affected.
As SSRIs have occasionally been associated with bleeding disorders and other effects on the blood, caution is advised when given with drugs known to affect platelet function.
Although different antidepressants have been used together under expert supervision in refractory cases of depression, severe adverse reactions including the serotonin syndrome may occur.
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