Ng Jason
Core Psychiatry Training, South London and Maudsley National Health Service (NHS) Foundation Trust, London, GBR.
Cureus. 2022 Apr 7;14(4):e23905. doi: 10.7759/cureus.23905. eCollection 2022 Apr.
Serotonin-producing tumours are a subset of neuroendocrine tumours which, when active, can lead to carcinoid syndrome caused by the secretion of vasoactive substances such as serotonin, histamine, and bradykinins. In addition to the common symptoms of flushing, diarrhoea, abdominal pain, and carcinoid heart disease, carcinoid syndrome is also known to cause psychiatric symptoms of depression as well as anxiety and, very rarely, psychotic symptoms. The treatment of the neuropsychiatric manifestations of the disease is also complicated by the concurrent use of somatostatin analogues, which also affect total circulating serotonin levels, a neurotransmitter implicated in the aforementioned psychiatric disorders. In this case report, we will discuss the management of psychotic depression in a 64-year-old female patient with a metastatic carcinoid tumour and our rationale for the use of vortioxetine in her treatment.
产生血清素的肿瘤是神经内分泌肿瘤的一个子集，当它们处于活跃状态时，会导致类癌综合征，这是由血清素、组胺和缓激肽等血管活性物质的分泌引起的。除了潮红、腹泻、腹痛和类癌心脏病等常见症状外，类癌综合征还会引起抑郁的精神症状以及焦虑，极少数情况下还会出现精神病性症状。该疾病的神经精神表现的治疗也因同时使用生长抑素类似物而变得复杂，生长抑素类似物也会影响总循环血清素水平，血清素是一种与上述精神障碍有关的神经递质。在本病例报告中，我们将讨论一名64岁患有转移性类癌肿瘤的女性患者的精神病性抑郁的管理，以及我们在她的治疗中使用伏硫西汀的理由。
