Abstract：
BACKGROUND: Serotonin toxicity is a well-described phenomenon that is commonly attributed to a variety of drug-drug combinations. Some unregulated herbal supplements have been implicated in the onset of serotonin toxicity, however, there is currently minimal literature available on the potential for black cohosh to contribute to rhabdomyolysis and serotonin toxicity, in spite of its known serotonergic properties.
METHODS: A middle-aged woman presented to the emergency department with serotonin toxicity and rhabdomyolysis shortly after taking black cohosh supplements in the setting of long-term dual antidepressant use. The serotonin toxicity and rhabdomyolysis resolved with IV fluids, benzodiazepines, and discontinuation of the offending drugs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients are sometimes not aware of how over-the-counter supplements might interact with their prescription medications. Female patients taking black cohosh to manage hot flashes and menopausal symptoms could be at risk for developing rhabdomyolysis and serotonin toxicity if they are also taking other serotonergic agents.
METHODS: A middle-aged woman presented to the emergency department with serotonin toxicity and rhabdomyolysis shortly after taking black cohosh supplements in the setting of long-term dual antidepressant use. The serotonin toxicity and rhabdomyolysis resolved with IV fluids, benzodiazepines, and discontinuation of the offending drugs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients are sometimes not aware of how over-the-counter supplements might interact with their prescription medications. Female patients taking black cohosh to manage hot flashes and menopausal symptoms could be at risk for developing rhabdomyolysis and serotonin toxicity if they are also taking other serotonergic agents.
摘要：
背景：5-羟色胺毒性是一种描述良好的现象，通常归因于多种药物-药物组合。一些不受管制的草药补充剂与5-羟色胺毒性的发作有关，然而,目前，关于黑升麻可能导致横纹肌溶解和5-羟色胺毒性的文献很少，尽管其已知的血清素能特性。
方法：一名中年妇女在长期使用双重抗抑郁药的情况下服用黑升麻补充剂后不久出现5-羟色胺毒性和横纹肌溶解症。5-羟色胺毒性和横纹肌溶解与静脉输液解决，苯二氮卓类药物,以及停止使用令人反感的药物.为什么紧急医生应该意识到这一点？：患者有时不知道非处方药补充剂可能与他们的处方药相互作用。服用黑升麻治疗潮热和更年期症状的女性患者，如果还服用其他5-羟色胺能药物，则可能有发生横纹肌溶解和5-羟色胺毒性的风险。
方法：一名中年妇女在长期使用双重抗抑郁药的情况下服用黑升麻补充剂后不久出现5-羟色胺毒性和横纹肌溶解症。5-羟色胺毒性和横纹肌溶解与静脉输液解决，苯二氮卓类药物,以及停止使用令人反感的药物.为什么紧急医生应该意识到这一点？：患者有时不知道非处方药补充剂可能与他们的处方药相互作用。服用黑升麻治疗潮热和更年期症状的女性患者，如果还服用其他5-羟色胺能药物，则可能有发生横纹肌溶解和5-羟色胺毒性的风险。
