Rothschild A J, Locke C A
McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA 02178.
J Clin Psychiatry. 1991 Dec;52(12):491-3.
Considerable controversy exists regarding the relationship between fluoxetine and the emergence of suicidal ideation. Three cases are presented of patients who were reexposed to fluoxetine after having previously made a serious suicide attempt during fluoxetine treatment. All three patients developed severe akathisia during retreatment with fluoxetine and stated that the development of the akathisia made them feel suicidal and that it had precipitated their prior suicide attempts. The akathisia and suicidal thinking abated upon the discontinuation of the fluoxetine or the addition of propranolol. The emergence of suicidal ideation during treatment with fluoxetine may be secondary to the development of akathisia. Gradual increments of fluoxetine dose and the prompt recognition and treatment of akathisia may reduce further the rare occurrence of suicidal ideation during fluoxetine treatment.
关于氟西汀与自杀观念的出现之间的关系存在相当大的争议。本文介绍了3例患者，他们在之前接受氟西汀治疗期间曾有过严重自杀企图，之后再次服用氟西汀。所有3例患者在重新使用氟西汀治疗期间均出现了严重的静坐不能，并表示静坐不能的出现使他们产生了自杀念头，且引发了他们之前的自杀企图。停用氟西汀或加用普萘洛尔后，静坐不能和自杀念头减轻。氟西汀治疗期间自杀观念的出现可能继发于静坐不能的发生。逐渐增加氟西汀剂量以及及时识别和治疗静坐不能可能会进一步降低氟西汀治疗期间罕见的自杀观念的发生。
