Thorpe Elizabeth L, Pizon Anthony F, Lynch Michael J, Boyer Jessica
Department of Pediatrics, Division of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Med Toxicol. 2010 Jun;6(2):168-71. doi: 10.1007/s13181-010-0021-x.
Although there are no documented cases of serotonin syndrome (SS) following bupropion ingestion alone in the literature, the ability of bupropion to potentiate serotonin levels and lead to SS is known. A 15-year-old boy was found at home hallucinating. He then developed tonic-clonic activity. Upon arrival in the emergency department, he was confused and restless. On exam, he had tachycardia, hypertension, dilated pupils and dry oral mucosa, normal tone and reflexes in his arms, but rigidity and +4 reflexes in his legs with sustained clonus at his ankles. He was admitted and treated with intravenous fluids and lorazepam for his agitation. A urine drug screen (via gas chromatography/mass spectrometry) was positive only for naproxen and bupropion. Serum bupropion and hydroxybupropion levels drawn 17 h after his reported ingestion were 280 (therapeutic range 50-100) and 3,100 ng/mL (therapeutic range <485), respectively. Within 24 h of his admission, the patient was awake with normal vital signs and neurologic exam. To our knowledge, there are only three reported cases demonstrating SS in conjunction with bupropion toxicity; however, none of these were secondary to bupropion alone.
虽然文献中没有单独服用安非他酮后出现血清素综合征（SS）的记录病例，但安非他酮增强血清素水平并导致血清素综合征的能力是已知的。一名15岁男孩在家中被发现出现幻觉。随后他出现了强直阵挛活动。到达急诊科时，他神志不清且躁动不安。检查发现，他有心动过速、高血压、瞳孔散大以及口腔黏膜干燥，双臂肌张力和反射正常，但双腿僵硬且反射亢进（4+），踝关节处有持续性阵挛。他被收治入院，并接受静脉输液和劳拉西泮治疗以缓解其躁动。尿液药物筛查（通过气相色谱/质谱法）仅显示萘普生和安非他酮呈阳性。在报告摄入药物17小时后测得的血清安非他酮和羟基安非他酮水平分别为280（治疗范围50 - 100）和3100 ng/mL（治疗范围< 485）。入院24小时内，患者清醒，生命体征和神经系统检查正常。据我们所知，仅有3例报告显示血清素综合征与安非他酮毒性有关；然而，这些病例均不是仅由安非他酮引起的。
