一名正在接受珠氯噻醇“阿克法斯”和氟西汀治疗的患者出现严重喉肌张力障碍。
Severe laryngeal dystonia in a patient receiving zuclopenthixol "Acuphase" and fluoxetine.
作者信息
Hood Sean, Orr Kenneth, Bennett Lynette, Davies Simon
机构信息
School of Psychiatry & Clinical Neurosciences (M521), University of Western Australia, QEII Medical Centre, Perth, WA, Australia.
出版信息
Australas Psychiatry. 2010 Apr;18(2):174-6. doi: 10.3109/10398560903473686.
OBJECTIVE
Prescribers are warned to be vigilant for potential cytochrome P450 mediated drug interactions; guidelines separately highlight risks of toxicity associated with zuclopenthixol acuphase. We previously examined potential cytochrome P450 interactions with zuclopenthixol and here describe dangerous side effects in a patient receiving zuclopenthixol acuphase and the selective serotonin reuptake inhibitor fluoxetine at high dose.
METHOD
We present the case of a patient established on fluoxetine 80 mg/day who subsequently received injected zuclopenthixol acuphase 100 mg.
RESULTS
Following zuclopenthixol acuphase administration, dangerous extra-pyramidal side effects were observed, including severe laryngeal dystonia necessitating emergency medical treatment.
CONCLUSIONS
Our observations of symptoms of zuclopenthixol toxicity are consistent with a cytochrome P450 2D6/3A4 interaction with fluoxetine. Previous evidence demonstrating this interaction included only patients taking fluoxetine up to 60 mg/day. This case extends the evidence base. In patients taking high dose fluoxetine, we advise marked reductions in the prescribed dose of zuclopenthixol acuphase.
目的
已警告开处方者要警惕潜在的细胞色素P450介导的药物相互作用；指南分别强调了与珠氯噻醇急性相相关的毒性风险。我们之前研究了细胞色素P450与珠氯噻醇之间的潜在相互作用，在此描述了一名接受高剂量珠氯噻醇急性相和选择性5-羟色胺再摄取抑制剂氟西汀治疗的患者出现的危险副作用。
方法
我们报告了一名患者的病例，该患者已确定每日服用80毫克氟西汀，随后接受了100毫克的珠氯噻醇急性相注射。
结果
在给予珠氯噻醇急性相后，观察到危险的锥体外系副作用，包括严重的喉部肌张力障碍，需要进行紧急治疗。
结论
我们对珠氯噻醇毒性症状的观察结果与细胞色素P450 2D6/3A4与氟西汀的相互作用一致。先前证明这种相互作用的证据仅包括每日服用氟西汀剂量达60毫克的患者。本病例扩展了证据基础。对于服用高剂量氟西汀的患者，我们建议大幅减少珠氯噻醇急性相的处方剂量。
Zotero 插件