Duplicate Therapy- SSRI+SSRI/SSRI+SNRI

How often do you encounter this combination working in retail and how do you resolve it? I have seen numerous patients that have prescriptions for escitalopram 10 mg + escitalopram 20 mg from the same prescriber, in addition to something like venlafaxine/duloxetine or fluoxetine and/or amitriptyline from another. To make it worse, most of these all are usually a (re)fill 05 and only have DUR comments that only contain 'dose ok' or 'patient on both' without providing any more information.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums