Charbonneau Annie
, B. Pharm, M. Sc., est pharmacienne ayant pour secteurs de pratique la médecine interne, la gériatrie ainsi que le Centre d'Information pharmacothérapeutique, Centre universitaire de santé McGill (CUSM), Montréal, Québec.
Can J Hosp Pharm. 2013 Jul;66(4):241-52. doi: 10.4212/cjhp.v66i4.1279.
Methylene blue is used in medical practice for various reasons. Recent findings point to a potential interaction with serotonin reuptake inhibitors (SRIs) that could lead to serotonergic toxicity.
To describe the risk of serotonergic toxicity associated with the interaction between methylene blue and SRIs.
Relevant publications were searched systematically via MEDLINE (1946 to March 21, 2013) and Embase (1974 to 2013, week 11) with the following search terms: "methylene blue", "methylthioninium", "monoamine oxidase inhibitors", "serotonin reup-take inhibitors", and "serotonin syndrome". No restrictions were applied in relation to the indication for methylene blue or the language of publication. The reference lists of identified articles were also searched.
Eighteen case reports and 2 case series were identified for inclusion. To date, no randomized controlled trials have been published.
The first case report indicating suspicion of an interaction between methylene blue and SRIs was published in 2003. Seventeen other case reports describing the same type of interaction have been published since then. The 2 case series provided data from about 325 parathyroidectomies in which methylene blue was used for staining. The 17 patients who experienced central nervous system toxicity were all taking SRIs in the preoperative period.
When administered in combination with SRIs, methylene blue may lead to serotonergic toxicity at doses as low as 0.7 mg/kg. Methylene blue would seem to have monoamine oxidase A inhibitory properties. Precautions should be taken to avoid this interaction. [Publisher's translation].
亚甲蓝在医学实践中有多种用途。最近的研究结果表明，它可能与5-羟色胺再摄取抑制剂（SRI）相互作用，从而导致5-羟色胺能毒性。
描述亚甲蓝与SRI相互作用相关的5-羟色胺能毒性风险。
通过MEDLINE（1946年至2013年3月21日）和Embase（1974年至2013年第11周）系统检索相关出版物，检索词如下：“亚甲蓝”、“亚甲硫堇”、“单胺氧化酶抑制剂”、“5-羟色胺再摄取抑制剂”和“5-羟色胺综合征”。对亚甲蓝的适应症或出版物语言未作限制。还检索了已识别文章的参考文献列表。
确定纳入18篇病例报告和2个病例系列。迄今为止，尚未发表随机对照试验。
2003年发表了首例怀疑亚甲蓝与SRI相互作用的病例报告。此后又发表了17篇描述同一类型相互作用的病例报告。2个病例系列提供了约325例甲状旁腺切除术中使用亚甲蓝染色的数据。17例出现中枢神经系统毒性的患者在术前均服用SRI。
与SRI联合使用时，亚甲蓝的剂量低至0.7mg/kg时可能导致5-羟色胺能毒性。亚甲蓝似乎具有单胺氧化酶A抑制特性。应采取预防措施避免这种相互作用。[出版商翻译]
