Lexapro (escitalopram): plus Prozac or cymbalta (duloxetine) can precipitate serotonergic syndrome. Any one of the agents can precipitate mania or hypo mania ( any chance you might be bipolar ? ) don't combine the agents without strict supervision ( heart rate, BP, temperature, etc) often switching from one serotonergic agent to another requires a wash out period of up to 2 weeks.
Answered 5/3/2016
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