Leinonen E, Koponen H, Lepola U
Psychiatric Research Clinic of Kuopio, Finland.
Ann Clin Psychiatry. 1993 Dec;5(4):255-7. doi: 10.3109/10401239309148825.
The correlation between high serum tricyclic antidepressant concentrations and central nervous system side effects has been well established. Only a few reports exist, however, on the relationship between the serum concentrations of selective serotonin reuptake inhibitors (SSRIs) and their toxic effects. In some cases, a high serum concentration of citalopram (> 600 nmol/L) in elderly patients has been associated with increased somnolence and movement difficulties. Widespread cognitive disorders, such as delirium, have not been previously linked with high blood levels of SSRIs. In this report, we describe a patient with acute hyperkinetic delirium connected with a high serum total fluoxetine (fluoxetine plus desmethylfluoxetine) concentration.
血清三环类抗抑郁药高浓度与中枢神经系统副作用之间的相关性已得到充分证实。然而，关于选择性5-羟色胺再摄取抑制剂（SSRI）血清浓度与其毒性作用之间关系的报道却很少。在某些情况下，老年患者血清西酞普兰浓度过高（>600 nmol/L）与嗜睡和运动困难增加有关。此前，广泛的认知障碍，如谵妄，与SSRI的高血药浓度并无关联。在本报告中，我们描述了一名患有急性运动性谵妄的患者，其血清总氟西汀（氟西汀加去甲氟西汀）浓度较高。
