Dorooshi Gholamali, Zoofaghari Shafeajafar, Meamar Rokhsareh
Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan, Iran.
J Res Pharm Pract. 2020 Oct 8;9(3):158-160. doi: 10.4103/jrpp.JRPP_19_105. eCollection 2020 Jul-Sep.
Serotonin toxicity is a common but often unrecognized toxicological condition. In most cases, a combination of two or more serotonergic drugs can cause serotonin syndrome. We describe a case of serotonin toxicity in a 17-year-old woman, secondary to suicidal ingestion of 1000 mg lamotrigine and 400 mg citalopram, which has been rarely reported. Our patient had a medical history of depression and was treated with lamotrigine and citalopram. She was brought to the emergency room with nausea, diaphoresis, agitation, shivering, tremor, vertigo, ataxia, mydriasis, nystagmus, hyperreflexia, myoclonus, tachycardia, tachypnea, and mild fever. The symptoms and signs were resolved within 3 days following hydration, sedation, and cyproheptadine. Minor cardiovascular symptoms are probably due to the less toxic dose of citalopram. Lamotrigine, especially in combination with other serotonergic drugs, should be considered a cause of serotonin toxicity.
血清素中毒是一种常见但常未被识别的毒理学状况。在大多数情况下，两种或更多种血清素能药物联合使用可导致血清素综合征。我们描述了一例17岁女性血清素中毒病例，该病例继发于自杀性摄入1000毫克拉莫三嗪和400毫克西酞普兰，这种情况鲜有报道。我们的患者有抑郁症病史，接受拉莫三嗪和西酞普兰治疗。她因恶心、出汗、烦躁、寒战、震颤、眩晕、共济失调、瞳孔散大、眼球震颤、反射亢进、肌阵挛、心动过速、呼吸急促和低热被送往急诊室。在补液、镇静和使用赛庚啶治疗后3天内，症状和体征得以缓解。轻微的心血管症状可能归因于西酞普兰剂量毒性较小。拉莫三嗪，尤其是与其他血清素能药物联合使用时，应被视为血清素中毒的一个原因。
