On the whole, no clinically significant interaction appears to occur between the
SSRIs and the
benzodiazepines or related drugs, such as cloral hydrate or
zaleplon. However, there is some evidence to suggest that the
metabolism of some
benzodiazepines (such as
alprazolam, bromazepam and
diazepam, and also possibly
midazolam, nitrazepam and triazolam) may be reduced by some
SSRIs (such as fluoxetine and fluvoxamine). There is some evidence to support the suggestion that sedation is likely to be increased by the concurrent use of
SSRIs and
benzodiazepines. Rare cases of hallucinations have been seen with
zolpidem and some
SSRIs.
No particular action is necessary but remember that the degree of sedation will depend on the individual patient and drug combination. Warn all patients of the potential effects, and counsel caution with driving or undertaking other skilled tasks.