Memory Clinic, Department of Neurological Science, University La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.
Neurol Sci. 2011 Jun;32(3):507-9. doi: 10.1007/s10072-011-0546-z. Epub 2011 Apr 14.
The serotonin toxicity (ST) is a potentially life-threatening adverse drug reaction results from therapeutic drug use, intentional self-poisoning, or inadvertent interactions between drugs. ST can be caused by a single or a combination of drugs with serotonergic activity due to excessive serotonergic agonism on central nervous system and peripheral serotonergic receptors (monoamine oxidase inhibitors, tricyclic antidepressants, SSRIs, opiate analgesics, over-the-counter cough medicines, antibiotics, weight-reduction agents, antiemetics, antimigraine agents, drugs of abuse, H2-antagonist and herbal products). The serotonin toxicity is often described as a clinical triad of mental-status changes (agitation and excitement with confusion), autonomic hyperactivity (diaphoresis, fever, tachycardia, and tachypnea), neuromuscular abnormalities (tremor, clonus, myoclonus, and hyperreflexia) and, in the advanced stage, spasticity; not all of these findings are consistently present. In this article, we describe two cases of ST due to interaction between Citalopram and two CYP2D6 inhibitors: Cimetidine and Topiramate and their clinical resolution after treatment discontinuation.
血清素毒性 (ST) 是一种潜在的危及生命的药物不良反应，是由治疗性药物使用、故意自我中毒或药物之间意外相互作用引起的。ST 可由单一药物或具有血清素能活性的药物组合引起，这是由于中枢神经系统和外周血清素受体过度的血清素激动作用（单胺氧化酶抑制剂、三环类抗抑郁药、SSRIs、阿片类镇痛药、非处方止咳药、抗生素、减肥药、止吐药、抗偏头痛药、滥用药物、H2 拮抗剂和草药产品）。血清素毒性通常被描述为精神状态变化的临床三联征（激越和兴奋伴意识混乱）、自主神经活性亢进（出汗、发热、心动过速和呼吸急促）、神经肌肉异常（震颤、阵挛、肌阵挛和反射亢进），在晚期还会出现痉挛；并非所有这些发现都始终存在。在本文中，我们描述了两例由于西酞普兰与两种 CYP2D6 抑制剂（西咪替丁和托吡酯）相互作用引起的 ST 病例，以及停用药物后临床缓解的情况。
