Swiss Toxicological Information Centre, Zurich, Switzerland.
Clin Toxicol (Phila). 2010 Mar;48(3):207-12. doi: 10.3109/15563650903585937.
Seizures are a recognized complication of acute overdose with the racemic (1:1 ratio of R- and S-enantiomers) selective serotonin reuptake inhibitor antidepressant citalopram.
We tested the hypothesis that escitalopram (the therapeutically active S-enantiomer of citalopram) causes fewer seizures in overdose than citalopram at comparable doses of the S-enantiomer.
Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.
316 citalopram and 63 escitalopram cases were analyzed. Somnolence, nausea, vomiting, tachycardia, QT prolongation, and tremor occurred with similar frequency in both groups. There was a striking difference in the frequency of single and multiple seizures: 43 cases (13.5%) in the citalopram group and 1 case (1.6%) with a single seizure in the escitalopram group (p=0.0065).
At comparable ingested doses of the S-enantiomer, the symptom profile for citalopram and escitalopram intoxications is similar except for seizures that occur more frequently in citalopram than in escitalopram poisoning.
抽搐是一种公认的急性过量服用（R-和 S-对映体的 1:1 比例）选择性 5-羟色胺再摄取抑制剂抗抑郁药西酞普兰的并发症。
我们测试了以下假设，即在可比剂量的 S-对映体下，艾司西酞普兰（西酞普兰的治疗活性 S-对映体）引起的过量抽搐比西酞普兰少。
对 1997 年至 2006 年间向德国、奥地利和瑞士中毒中心报告的西酞普兰和艾司西酞普兰过量服用的病例进行多中心回顾性分析。
分析了 316 例西酞普兰和 63 例艾司西酞普兰病例。两组患者均出现嗜睡、恶心、呕吐、心动过速、QT 延长和震颤，其发生率相似。两组单次和多次抽搐的发生率存在显著差异：西酞普兰组有 43 例（13.5%），艾司西酞普兰组有 1 例（1.6%）出现单次抽搐（p=0.0065）。
在可比摄入的 S-对映体剂量下，西酞普兰和艾司西酞普兰中毒的症状谱相似，但抽搐的发生率在西酞普兰中毒中比艾司西酞普兰中毒更为常见。
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