Situations where drug combination use may increase the risk of self-harm usually involve synergistic effects of central nervous system effects, mood swings, or cognitive function effects. The following are the drug combinations and mechanisms that are known or may increase the risk： ### 1. **Antidepressants (SSRI/SNRI) and benzodiazepines** -**Combination example **: Fluoxetine (SSRI) + Alprazolam. -**Risk mechanism**: SSRI may increase anxiety or insomnia in the early stage. Although benzodiazepines relieve symptoms, they may reduce judgment and increase the risk of impulsive behavior due to excessive sedation. Sudden cessation of benzodiazepines may cause withdrawal anxiety. ### 2. **Antidepressants and antipsychotics** -**Combination example **: Fluoxetine + quetiapine. -**Risk mechanism**: The side effects of antipsychotics (such as the inability to sit still) are superimposed with the activation effects of antidepressants, which may lead to agitation or emotional instability, especially in patients with bipolar disorder. ### 3. **Mixed use of central nervous system inhibitors** -**Example of combination **: Alcohol + benzodiazepines (such as diazepam). -**Risk mechanism**: Synergistic inhibition of the central nervous system leads to blurred consciousness, decreased judgment, and may cause impulsive self-harm. ### 4. **Stimulants and antidepressants** -**Combination example **: methylphenidate (ADHD drug) + sertraline (SSRI). -**Risk mechanism**: Stimulants may exacerbate anxiety or insomnia, superimpose with the activation effect of SSRI, and may increase the risk of mood swings, especially in adolescents. ### 5. **Isotretinoin and psychotropic drugs** -** Combination example **: Isotretinoin (acne treatment) + SSRI. -**Risk mechanism**: Isotretinoin alone may be associated with depressive symptoms, and if the effect is insufficient when combined with antidepressants, it may worsen emotional problems. ### 6. **Opiate drugs and sedatives** -**Combination example **: Oxycodone + lorazepam. -**Risk mechanism**: Confusion of consciousness or low mood other than respiratory depression may indirectly increase the tendency to self-harm. ### 7. **Lithium salts and NSAIDs** -**Combination example **: Lithium salt (bipolar therapy) + Ibuprofen. -**Risk mechanism**: NSAIDs increase lithium blood concentration, which may lead to poisoning (tremor, confusion of consciousness), and indirectly cause abnormal behavior. ### Precautions： -**Individual differences**: Adolescents, the elderly, or those who are already suicidal are at higher risk. -**Dosage and course of treatment**: High doses or rapid dose adjustment may increase the risk. -**Withdrawal response**: Sudden withdrawal of SSRI or benzodiazepines may cause mood deterioration. ### Important reminder： -**Professional consultation**: Any drug adjustment must be carried out under the guidance of a doctor. -**Monitoring and early warning**: Closely observe emotional or behavioral changes in the initial stage of medication and when the dose changes. -**Emergency**: If you have thoughts of self-injury, contact medical personnel or emergency services immediately. This information is designed to increase alertness, and the specific medication needs to be evaluated individually.