Saguin Emeric, Keou S, Ratnam C, Mennessier C, Delacour H, Lahutte B
Department of Psychiatry, Hopital d'Instruction des Armees Begin, Saint Mande, France.
Department of Medicine, Hopital d'Instruction des Armees Begin, Saint Mande, Île-de-France, France.
J R Army Med Corps. 2018 May;164(2):127-129. doi: 10.1136/jramc-2018-000939. Epub 2018 Apr 9.
Rhabdomyolysis is a potential complication of psychotropic drugs use and may potentially lead to life-threatening complications, such as an acute renal failure. We describe the case of a 40-year-old military soldier suffering from post-traumatic stress disorder was admitted for an adaptation of his treatment. Mirtazapine was introduced and quetiapine increased. Two days later, the patient presented with severe rhabdomyolysis syndrome. Mirtazapine administration was paused and intravenous hydration commenced. Shortly after the creatine kinase levels decreased enabling mirtazapine to be reintroduced without complication. It is our opinion that 5-hydroxytryptamine 2a serotonergic receptors inhibition (related to mirtazapine and quetiapine) associated with muscle training was responsible for inducing rhabdomyolysis. This must be kept in mind when psychotropic medications are adjusted, especially in an athletic population such as military.
横纹肌溶解是使用精神药物的一种潜在并发症，可能会导致危及生命的并发症，如急性肾衰竭。我们描述了一名40岁患有创伤后应激障碍的军人病例，他因调整治疗方案入院。开始使用米氮平并增加了喹硫平的剂量。两天后，患者出现严重的横纹肌溶解综合征。暂停使用米氮平并开始静脉补液。肌酸激酶水平在不久后下降，使得米氮平能够重新使用且未出现并发症。我们认为，与米氮平和喹硫平相关的5-羟色胺2a血清素能受体抑制作用与肌肉训练共同导致了横纹肌溶解。在调整精神药物时，尤其是在军人等运动员群体中，必须牢记这一点。
