Krol D G H, Nolen W A
Symfora Groep, De Meregaard, Almere.
Tijdschr Psychiatr. 2006;48(5):405-8.
A woman with a recurrent episode of a depression that hitherto had been unipolar developed a hypomania the day after her treatment with paroxetine 20 mg/day was switched to venlafaxine 75 mg/day. The hypomanic symptoms subsided gradually as the dosage was reduced and the patient thereafter remained in a euthymic state while on venlafaxine at a dose of 18.75 mg/day. Three possible explanations are discussed for the patient's response: there was a pharmacokinetic interaction between paroxetine and venlafaxine, the patient had an idiosyncratic reaction to venlafaxine or venlafaxine inhibited the re-uptake of norepinephrin.
一名既往为单相抑郁且病情反复的女性，在将每日20毫克帕罗西汀治疗换成每日75毫克文拉法辛治疗后的第二天出现了轻躁狂。随着剂量减少，轻躁狂症状逐渐消退，此后患者在每日18.75毫克文拉法辛治疗时保持心境正常状态。文中讨论了对于该患者反应的三种可能解释：帕罗西汀与文拉法辛之间存在药代动力学相互作用、患者对文拉法辛有特异反应或文拉法辛抑制了去甲肾上腺素的再摄取。
