Huska Matthew T, Catalano Glenn, Catalano Maria C
Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine, Tampa, FL, USA.
CNS Spectr. 2007 Apr;12(4):270-4. doi: 10.1017/s1092852900021027.
Escitalopram is the newest selective serotonin reuptake inhibitor (SSRI) available for use in the United States. It has been approved for the treatment of major depression and generalized anxiety disorder. It is the S-enantiomer of the SSRI citalopram and is highly serotonin specific as it has minimal effect on the reuptake of dopamine or norepinephrine. It is also a well-tolerated medication, with a side-effect profile comparable to the other SSRIs. While a number of side effects have been seen during escitalopram therapy, such as insomnia, nausea, and increased sweating, there are no reported cases of serotonin syndrome associated with escitalopram therapy to date. We present the case of a 24-year-old woman who developed serotonin syndrome after an increase in her escitalopram to 30 mg/day. We will review the diagnostic criteria of serotonin syndrome and the clinical scenarios in which serotonin syndrome can develop. We will also discuss the proposed treatments and role that polypharmacology may play in the development of this clinical entity.
艾司西酞普兰是美国市面上最新可用的选择性5-羟色胺再摄取抑制剂（SSRI）。它已被批准用于治疗重度抑郁症和广泛性焦虑症。它是SSRI西酞普兰的S-对映体，对5-羟色胺具有高度特异性，因为它对多巴胺或去甲肾上腺素的再摄取影响极小。它也是一种耐受性良好的药物，其副作用与其他SSRI相当。虽然在艾司西酞普兰治疗期间出现了一些副作用，如失眠、恶心和出汗增多，但迄今为止尚无与艾司西酞普兰治疗相关的5-羟色胺综合征报告病例。我们报告一例24岁女性在将艾司西酞普兰剂量增加至30毫克/日后出现5-羟色胺综合征的病例。我们将回顾5-羟色胺综合征的诊断标准以及可能发生该综合征的临床情况。我们还将讨论所建议的治疗方法以及联合用药在这一临床病症发生过程中可能起到的作用。
