Morris Rachel, Matthes Jean
Neonatal Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK.
BMJ Case Rep. 2015 May 6;2015:bcr2015209418. doi: 10.1136/bcr-2015-209418.
A late preterm presented with tachypnoea, jitteriness, irritability and low grade fever. Blood gas showed a compensated metabolic acidosis. His mother was taking the selective serotonin reuptake inhibitor (SSRI) fluoxetine, 60 mg/day, and he was exclusively breast-fed. The baby's serum level of fluoxetine on day 8 was within the adult therapeutic range and his symptoms were ascribed to fluoxetine toxicity. On changing to formula feeds, his symptoms resolved. SSRIs are commonly administered during pregnancy, but SSRI toxicity in infants is rarely reported. It is possible that this condition is under diagnosed or, alternatively, misdiagnosed as SSRI withdrawal in breast fed infants whose mothers are on SSRIs. There is limited research looking at serotonin excess in neonates, making case reports such as this important in our learning. Increased awareness may prompt more frequent measurements of blood levels in breast-fed infants whose mothers are on SSRIs.
一名晚期早产儿出现呼吸急促、震颤、易激惹和低热。血气分析显示为代偿性代谢性酸中毒。其母亲正在服用选择性5-羟色胺再摄取抑制剂（SSRI）氟西汀，每日60毫克，且该婴儿纯母乳喂养。婴儿在第8天的血清氟西汀水平处于成人治疗范围内，其症状归因于氟西汀中毒。改用配方奶喂养后，他的症状消失。SSRI在孕期常用，但婴儿的SSRI中毒鲜有报道。这种情况有可能未被诊断出来，或者被误诊为母亲服用SSRI的母乳喂养婴儿的SSRI戒断症状。关于新生儿5-羟色胺过量的研究有限，因此这样的病例报告对我们的认知很重要。提高认识可能会促使更频繁地检测母亲服用SSRI的母乳喂养婴儿的血药浓度。
