Apelland T, Gedde-Dahl T, Dietrichson T
Medisinsk avdeling Diakonhjemmets sykehus, Oslo.
Tidsskr Nor Laegeforen. 1999 Feb 20;119(5):647-50.
The serotonin syndrome is a rare, but potentially fatal complication to treatment with serotonin reuptake inhibitors. Due to increasing prescription of these drugs the condition must be expected to occur more often. Symptoms include changes in mental status (confusion, agitation and restlessness), neuromuscular symptoms (shivering, ataxia, myoclonus and hyperreflexia) and autonomic dysfunction (fever, diaphoresis, hypertension and tachycardia). The syndrome is most often produced by concurrent use of two or more drugs that enhance serotonin neurotransmission. Monotherapy may also elicit the syndrome. We report the development of serotonin syndrome with a fatal outcome in a patient treated with paroxetin++. Interactions with alimemazin++, melperon++ and karbamazepin may have contributed to the outcome. The serotonin syndrome usually resolves within 24 hours when the suspected drugs are discontinued. However, there may be a dramatic progression of symptoms requiring intensive supportive care to prevent death.
血清素综合征是一种罕见但可能致命的5-羟色胺再摄取抑制剂治疗并发症。由于这些药物的处方量不断增加，预计这种情况会更频繁地发生。症状包括精神状态改变（意识模糊、激动和烦躁不安）、神经肌肉症状（颤抖、共济失调、肌阵挛和反射亢进）以及自主神经功能障碍（发热、多汗、高血压和心动过速）。该综合征最常由同时使用两种或更多增强5-羟色胺神经传递的药物引起。单一疗法也可能引发该综合征。我们报告了一名接受帕罗西汀治疗的患者发生血清素综合征并导致致命后果的情况。与阿利马嗪、美哌隆和卡马西平的相互作用可能导致了这一结果。当停用可疑药物时，血清素综合征通常会在24小时内缓解。然而，症状可能会急剧进展，需要强化支持治疗以防止死亡。
