Duke University Hospital Pharmacy, Durham, NC, USA.
Psychosomatics. 2010 Sep-Oct;51(5):437-42. doi: 10.1176/appi.psy.51.5.437.
Serotonin syndrome is a condition resulting from an overabundance of serotonin at postsynaptic receptors. The syndrome usually responds to cyproheptadine and benzodiazepines. However, some patients do not respond to conventional treatment.
The authors report on the history and management of a patient, a 55-year-old man, who had taken a massive overdose of paroxetine, controlled-release.
The authors present a case report of history and treatment. Paroxetine levels were measured on Days 3 and 7 after admission, with rising values of the drug. The patient received a course of cyproheptadine and lorazepam, to which he was unresponsive, and he was transferred to the Medical Intensive Care Unit for heavy sedation.
The patient had initially presented with minor symptoms of serotonin syndrome, but these quickly progressed in severity, and he eventually died from resulting complications: a pulmonary embolism 9 days after admission, despite appropriate prophylaxis with enoxaparin.
The authors are the first to report on a paroxetine overdose of this magnitude, and they provide one of the few reports on a prolonged course of serotonin syndrome that was unresponsive to standard treatment.
血清素综合征是一种由于突触后受体中血清素过多而引起的病症。该综合征通常对赛庚啶和苯二氮䓬类药物有反应。然而，一些患者对常规治疗没有反应。
作者报告了一名 55 岁男性患者的病史和治疗情况，该患者过量服用了帕罗西汀控释片。
作者报告了一例病史和治疗情况。入院后第 3 天和第 7 天测量了帕罗西汀的水平，药物水平升高。该患者接受了赛庚啶和劳拉西泮治疗，但没有反应，并被转至重症监护病房进行深度镇静。
该患者最初出现了轻微的血清素综合征症状，但很快就加重了，最终因并发症而死亡：入院后 9 天发生肺栓塞，尽管使用依诺肝素进行了适当的预防。
作者首次报告了如此大剂量的帕罗西汀过量，并且提供了少数对标准治疗无反应的长时间血清素综合征病程之一的报告。
