Richard I H, Kurlan R, Tanner C, Factor S, Hubble J, Suchowersky O, Waters C
University of Rochester Medical Center, Department of Neurology, NY 14642-8673, USA.
Neurology. 1997 Apr;48(4):1070-7. doi: 10.1212/wnl.48.4.1070.
The manufacturer of deprenyl (selegeline; Eldepryl) (Somerset Pharmaceuticals, Tampa, FL) recently advised physicians to avoid prescribing the drug in combination with an antidepressant because of potentially serious CNS toxicity that may represent the serotonin syndrome. Manifestations of the serotonin syndrome vary but may include changes in mental status and motor and autonomic function. To better estimate the frequency of the serotonin syndrome in patients with Parkinson's disease (PD) treated with deprenyl and an antidepressant, we surveyed all investigators in the Parkinson Study Group. Based on estimates provided by the 47 investigators (75%) who responded, 4,568 patients were treated with the combination of deprenyl and an antidepressant medication. Eleven patients (0.24%) were reported to have experienced symptoms possibly consistent with the serotonin syndrome. Only two patients (0.04%) experienced symptoms considered to be serious. No deaths were reported. We also reviewed all published case reports and adverse experiences reported to the U.S. Food and Drug Administration and the manufacturer of Eldepryl. Available information indicates that serious adverse experiences resulting from the combined use of deprenyl and an antidepressant medication in patients with PD are quite rare and that the frequency of the true "serotonin syndrome" is even rarer.
司来吉兰（Selegeline；商品名Eldepryl）的制造商（佛罗里达州坦帕市的萨默塞特制药公司）最近建议医生避免将该药与抗抑郁药联合使用，因为可能会出现潜在的严重中枢神经系统毒性，这可能是血清素综合征的表现。血清素综合征的表现各不相同，但可能包括精神状态、运动及自主神经功能的改变。为了更好地估计接受司来吉兰和抗抑郁药治疗的帕金森病（PD）患者中血清素综合征的发生率，我们对帕金森研究小组的所有研究人员进行了调查。根据47名做出回应的研究人员（占75%）提供的估计，有4568名患者接受了司来吉兰和抗抑郁药的联合治疗。据报告，有11名患者（0.24%）出现了可能与血清素综合征相符的症状。只有两名患者（0.04%）出现了被认为严重的症状。未报告死亡病例。我们还查阅了所有已发表的病例报告以及向美国食品药品监督管理局和Eldepryl制造商报告的不良事件。现有信息表明，帕金森病患者联合使用司来吉兰和抗抑郁药导致严重不良事件的情况非常罕见，真正的“血清素综合征”发生率甚至更低。
