Meamar Rokhsareh, Rabiei Zahra, Feizi Awat, Namvar Melika, Eizadi-Mood Nastaran
Department of Clinical Toxicology, School of Medicine, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan University of Medical Sciences, Isfahan, Iran.
Emerg Med Int. 2025 May 3;2025:4727543. doi: 10.1155/emmi/4727543. eCollection 2025.
Due to the increasing concern about selective serotonin reuptake inhibitors (SSRIs) poisoning, specifically the risk of serotonin syndrome (SS), and the QT-prolonging effects of certain SSRIs, we evaluated the clinical presentations and outcomes of patients who overdosed on single SSRIs. We carried out a cross-sectional study at a Poisoning Emergency referal center in Isfahan, Iran, involving 101 patients who had taken a single SSRI drug and were hospitalized between January 2021 and January 2024. Information on demographics, toxicological features, clinical symptoms, electrocardiogram (ECG) findings, and outcomes was gathered. The average age of the patients was 26.98 ± 10.57 years. Females outnumbered males (male to female ratio was 1:3.8). Sertraline was the most frequently ingested SSRI (43.6%), followed by fluoxetine (18.8%). Gastrointestinal symptoms (nausea and vomiting) were the most common clinical signs ( = 30, 29.7%). Six patients (5.9%) were diagnosed with SS. Only one patient experienced a brief, self-limiting seizure after consuming 4 g of sertraline. ECG showed QT interval prolongation (QT prolongation) in 32 patients (31.6%). One patient developed a first-degree AV block after taking 600 mg of citalopram. There was no significant difference in QT prolongation or SS based on the type of SSRI used. All patients survived without complications. This study indicates that overdosing on a single SSRI typically results in mild to moderate clinical manifestations. Cardiac issues, such as QT prolongation, were relatively common among our patients.
由于对选择性5-羟色胺再摄取抑制剂（SSRI）中毒的关注度不断增加，特别是血清素综合征（SS）的风险，以及某些SSRI的QT间期延长作用，我们评估了过量服用单一SSRI患者的临床表现和结局。我们在伊朗伊斯法罕的一家中毒急救转诊中心开展了一项横断面研究，纳入了101例服用单一SSRI药物并于2021年1月至2024年1月期间住院的患者。收集了有关人口统计学、毒理学特征、临床症状、心电图（ECG）结果和结局的信息。患者的平均年龄为26.98±10.57岁。女性多于男性（男女比例为1:3.8）。舍曲林是最常摄入的SSRI（43.6%），其次是氟西汀（18.8%）。胃肠道症状（恶心和呕吐）是最常见的临床体征（n = 30，29.7%）。6例患者（5.9%）被诊断为SS。只有1例患者在服用4 g舍曲林后出现短暂的自限性癫痫发作。ECG显示32例患者（31.6%）QT间期延长（QT延长）。1例患者在服用600 mg西酞普兰后出现一度房室传导阻滞。基于所使用的SSRI类型，QT延长或SS方面无显著差异。所有患者均存活且无并发症。这项研究表明，过量服用单一SSRI通常会导致轻度至中度的临床表现。心脏问题，如QT延长，在我们的患者中相对常见。
