Department of Clinical Pharmacy, College of Pharmacy, The University of Tennessee, Knoxville, TN, USA.
J Clin Pharm Ther. 2012 Oct;37(5):610-3. doi: 10.1111/j.1365-2710.2012.01344.x. Epub 2012 Mar 27.
Serotonin syndrome can be a rare but life-threatening condition that is commonly the result of a drug-drug interaction causing excessive serotonin activity. The symptoms associated with serotonin syndrome can include hyperthermia, mental status changes, autonomic hyperactivity and neuromuscular abnormalities, all of which can be concealed in the critically ill patient owing to concomitant therapies. The objective of this case report is to describe a probable drug-drug interaction between buspirone and linezolid, and to highlight the potential confounding effects of hypothermia in this case.
We present a case of a 28-year-old man who potentially developed serotonin syndrome after coadministration of buspirone and linezolid while being therapeutically cooled for traumatic brain injury. The patient developed hyperthermia, hypertension and tachycardia when buspirone and linezolid were administered concomitantly for 2 days. Symptoms resolved within 24 h after discontinuation of both medications.
Caution should be used in patients receiving multiple serotonergic agents in addition to therapeutic hypothermia. The use of therapeutic hypothermia may mask the symptoms associated with serotonin syndrome, thus delaying the diagnosis and treatment of this potentially deadly condition. If a patient requires the combination of such medications, close monitoring for the symptoms of serotonin syndrome is warranted.
血清素综合征是一种罕见但危及生命的疾病，通常是药物相互作用导致血清素过度活跃的结果。与血清素综合征相关的症状可能包括发热、精神状态改变、自主神经活性亢进和神经肌肉异常，由于同时进行的治疗，所有这些症状都可能在重症患者中被掩盖。本病例报告的目的是描述可能发生在丁螺环酮和利奈唑胺之间的药物相互作用，并强调在这种情况下低温的潜在混杂影响。
我们报告了一例 28 岁男性患者，在因创伤性脑损伤接受治疗性降温的同时合用丁螺环酮和利奈唑胺，可能发生了血清素综合征。当丁螺环酮和利奈唑胺同时使用 2 天时，患者出现发热、高血压和心动过速。停用两种药物后 24 小时内症状缓解。
在接受多种血清素能药物治疗的患者中，应谨慎使用治疗性低温。治疗性低温可能会掩盖与血清素综合征相关的症状，从而延迟这种潜在致命疾病的诊断和治疗。如果患者需要联合使用此类药物，应密切监测血清素综合征的症状。
