Bucasia, Queensland, Australia.
Headache. 2010 Feb;50(2):264-72. doi: 10.1111/j.1526-4610.2009.01575.x. Epub 2009 Nov 17.
The US Food and Drug Administration (FDA) have suggested that fatal serotonin syndrome (SS) is possible with selective serotonin reuptake inhibitors (SSRIs) and triptans: this warning affects millions of patients as these drugs are frequently given simultaneously. SS is a complex topic about which there is much misinformation. The misconception that 5-HT1A receptors can cause serious SS is still widely perpetuated, despite quality evidence that it is activation of the 5-HT2A receptor that is required for serious SS. This review considers SS involving serotonin agonists: ergotamine, lysergic acid diethylamide, bromocriptine, and buspirone, as well as triptans, and reviews the experimental foundation underpinning the latest understanding of SS. It is concluded that there is neither significant clinical evidence, nor theoretical reason, to entertain speculation about serious SS from triptans and SSRIs. The misunderstandings about SS exhibited by the FDA, and shared by the UK Medicines and Healthcare products Regulatory Agency (in relation to methylene blue), are an important issue with wide ramifications.
美国食品和药物管理局（FDA）曾表示，使用选择性 5-羟色胺再摄取抑制剂（SSRIs）和曲坦类药物可能会导致致命的 5-羟色胺综合征（SS）：由于这些药物经常同时使用，因此这一警告影响了数百万患者。SS 是一个复杂的话题，存在很多错误信息。尽管有高质量的证据表明，严重 SS 需要 5-HT2A 受体的激活，但人们仍然广泛误解 5-HT1A 受体可能导致严重 SS。这篇综述考虑了涉及 5-羟色胺激动剂的 SS：麦角胺、麦角酸二乙酰胺、溴隐亭和丁螺环酮，以及曲坦类药物，并回顾了支持对 SS 最新理解的实验基础。结论是，既没有明显的临床证据，也没有理论依据，可以推测曲坦类药物和 SSRIs 会引起严重的 SS。FDA 和英国药品和保健产品监管局（与亚甲蓝有关）对 SS 的误解是一个具有广泛影响的重要问题。
