Ruiz de Villa Ariel, Jones Tyler, Lleshi Amina, Macahuachi Monica, Lamar Katie, Bazikian Yvette
Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.
Internal Medicine, HCA Healthcare North Florida Regional Medical Center, Gainesville, USA.
Cureus. 2021 Nov 30;13(11):e20059. doi: 10.7759/cureus.20059. eCollection 2021 Nov.
Serotonin syndrome (SS), a potentially life-threatening condition, typically occurs due to polypharmacy and interaction with multiple serotonergic agents. The case presented here is based on a serotonin syndrome (SS) diagnosis, precipitated by newly prescribed tramadol in conjunction with previously prescribed serotonergic medications. A 79-year-old woman receiving combined citalopram and trazodone for major depressive disorder alongside oxycodone for chronic pain developed generalized weakness, tremors, altered mentation, episodic auditory and visual hallucinations, fever, tachypnea, tachycardia, and diaphoresis a few days after tramadol was prescribed for pain. On clinical examination to medication reconciliation, and ruling out other causes of altered mental status, it became evident that the addition of tramadol had resulted in acute serotonin toxicity. SS is important to recognize because many healthcare providers encounter it during their careers. This diagnosis is essential to include in the differential diagnosis, especially when a medication not often associated with serotonin, like opiates, is the culprit.
血清素综合征（SS）是一种可能危及生命的疾病，通常由于联合用药以及与多种血清素能药物相互作用而发生。本文所述病例基于血清素综合征（SS）的诊断，由新开具的曲马多与先前开具的血清素能药物共同引发。一名79岁女性因重度抑郁症接受西酞普兰和曲唑酮联合治疗，同时因慢性疼痛服用羟考酮，在开具曲马多治疗疼痛几天后，出现全身无力、震颤、精神状态改变、发作性听觉和视觉幻觉、发热、呼吸急促、心动过速和多汗。经临床检查以核对用药情况并排除其他导致精神状态改变的原因后，发现添加曲马多导致了急性血清素中毒。认识血清素综合征很重要，因为许多医疗保健提供者在其职业生涯中都会遇到这种情况。这种诊断对于鉴别诊断至关重要，尤其是当一种通常与血清素无关的药物（如阿片类药物）是罪魁祸首时。
