Weiner A L, Tilden F F, McKay C A
Connecticut Poison Control Center, USA.
Conn Med. 1997 Nov;61(11):717-21.
We present the case of a 35-year-old woman who developed serotonin syndrome after receiving a single dose of the cyclic antidepressant imipramine (Tofranil). She was already being treated for depression with paroxetine (Paxil), a selective serotonin reuptake inhibitor. Two hours after receiving imipramine, the patient developed tachycardia, delirium, bizarre movements, and myoclonus, all classic findings of serotonin syndrome. Her antidepressants were discontinued and she was treated with intravenous fluids, sedation, and a short course of cyproheptadine, a serotonin receptor antagonist. All symptoms resolved completely within 24 hours. In this case report, we review the drug interactions that can precipitate serotonin syndrome, and give recommendations for the diagnosis and treatment of this potentially fatal disorder.
我们报告一例35岁女性病例，该患者在单次服用三环类抗抑郁药丙咪嗪（托弗尼尔）后出现血清素综合征。她当时已在服用选择性5-羟色胺再摄取抑制剂帕罗西汀（帕罗西汀）治疗抑郁症。服用丙咪嗪两小时后，患者出现心动过速、谵妄、怪异动作和肌阵挛，这些都是血清素综合征的典型表现。停用了她的抗抑郁药，并给予静脉补液、镇静治疗以及短期使用5-羟色胺受体拮抗剂赛庚啶治疗。所有症状在24小时内完全缓解。在本病例报告中，我们回顾了可引发血清素综合征的药物相互作用，并给出了针对这种潜在致命疾病的诊断和治疗建议。
