METHODS: A 30-year-old Caucasian woman with a history of depression on regular fluvoxamine presented to the emergency department with right-sided facial and lower limb twitching. The patient had recently been prescribed sumatriptan for migraines and had taken her first ever dose shortly prior to the onset of symptoms. She was tachycardic, diaphoretic, and hypertonic on initial assessment with bilateral lower limb and ocular clonus. Electrocardiogram showed sinus tachycardia with QT interval under the treatment interval, and pathology and imaging findings were unremarkable. Her symptoms improved with supportive management and cyproheptadine.
CONCLUSIONS: This patient\'s presentation fulfilled both Sternbach and Hunter criteria for serotonin toxicity, illustrating a potential case of serotonin toxicity as a result of drug interaction between a selective serotonin reuptake inhibitor and a triptan.
方法:一名30岁的白种人女性,有抑郁症史,定期服用氟伏沙明,出现右侧面部和下肢抽搐,到急诊科就诊。该患者最近服用了舒马曲坦治疗偏头痛,并在症状发作前不久服用了她的第一次剂量。她是心动过速,发汗,和高渗的初步评估与双侧下肢和眼阵络。心电图显示窦性心动过速,在治疗间隔下有QT间期,病理和影像学检查结果无明显变化。通过支持性治疗和赛庚啶,她的症状得到了改善。
结论:该患者的表现符合Sternbach和Hunter关于5-羟色胺毒性的标准,说明了由于选择性5-羟色胺再摄取抑制剂和曲坦之间的药物相互作用而导致的5-羟色胺毒性的潜在情况。