Shimizu K, Watanabe M, Kodama Y, Nomura S
Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 1998 Aug;18(4):129-32.
Although a 76-year-old woman with a diagnosis of depression began a course of maprotiline, the drug was discontinued after 14 days when she developed a rash. She was started on lofepramine in substitution for maprotiline. Four years later, lofepramine treatment was stopped and to amoxapine treatment introduced due to the aggravation of depressive symptoms. On the second day of this regimen, she developed a pruritic rash. She stopped the medication immediately. Because the rash disappeared gradually, lofepramine treatment was restarted. But her recovery was restrained and new skin lesions developed. Again, she stopped the medication, and the rash cleared within several days. This case suggests the existence of cross-allergenicity between tricyclic antidepressants and maprotiline.
一名被诊断为抑郁症的76岁女性开始服用马普替林，但14天后出现皮疹，遂停药。随后她开始服用洛非帕明以替代马普替林。四年后，由于抑郁症状加重，停用了洛非帕明，开始使用阿莫沙平治疗。在该治疗方案的第二天，她出现了瘙痒性皮疹，立即停药。由于皮疹逐渐消退，于是重新开始使用洛非帕明治疗。但她的康复受到抑制，又出现了新的皮肤损害。她再次停药，皮疹在几天内消退。该病例提示三环类抗抑郁药与马普替林之间存在交叉过敏反应。
