Wilson A D, Howell C, Waring W S
J Toxicol Sci. 2007 Feb;32(1):97-101. doi: 10.2131/jts.32.97.
Rhabdomyolysis has been reported after venlafaxine ingestion. We wished to characterize the prevalence of this adverse effect in a realistic clinical setting. Therefore, a retrospective casenote review was performed, including 235 patients admitted to the Royal Infirmary of Edinburgh due to venlafaxine overdose between January 2000 and June 2006. Seizures occurred in 8.9% of the study population. Patients who suffered seizures had ingested larger quantities of venlafaxine than those who did not develop seizures; median (interquartile range) 2800 mg (2006-4350 mg) versus 1500 mg (900-2700 mg, p = 0.001). Raised CK values were more prevalent in those with seizures than those without seizures (61.1% versus 25.7% respectively, p = 0.004). Nonetheless, a positive correlation was found between the quantity of venlafaxine ingested and CK across the whole group (rho = 0.201, 95% confidence interval 0.045-0.347), and in patients who had not developed seizures (rho = 0.174, 95% confidence interval 0.009-0.331). Venlafaxine overdose is associated with a high prevalence of acute muscle injury, both in patients who develop seizures and in those who do not. The clinical significance of this association merits further consideration.
文拉法辛摄入后曾有横纹肌溶解的报道。我们希望在实际临床环境中确定这种不良反应的发生率。因此，我们进行了一项回顾性病例记录审查，纳入了2000年1月至2006年6月期间因文拉法辛过量而入住爱丁堡皇家医院的235例患者。8.9%的研究人群发生了癫痫发作。发生癫痫发作的患者摄入的文拉法辛量高于未发生癫痫发作的患者；中位数（四分位间距）分别为2800毫克（2006 - 4350毫克）和1500毫克（900 - 2700毫克，p = 0.001）。癫痫发作患者的肌酸激酶（CK）值升高比未发作癫痫的患者更常见（分别为61.1%和25.7%，p = 0.004）。尽管如此，在整个研究组中，文拉法辛摄入量与CK之间存在正相关（rho = 0.201，95%置信区间0.045 - 0.347），在未发生癫痫发作的患者中也存在正相关（rho = 0.174，95%置信区间0.009 - 0.331）。文拉法辛过量与急性肌肉损伤的高发生率相关，无论患者是否发生癫痫发作。这种关联的临床意义值得进一步探讨。
