背景:最近的出版物涉及文拉法辛(VLX)中毒中低血糖的存在,具体取决于剂量。我们的目的是分析VLF过量引起的低血糖患者的临床特征。
方法:在巴利阿里群岛(2020-2023年)进行的回顾性研究。
方法:VLX+O-去甲基-文拉法辛(O-VLX)的血清浓度>800ng/mL。比较有无低血糖患者的特点。
结果:包括21名患者,8例(38.1%)伴低血糖。两组的剂量均未发现差异。VLX+O-VLX的峰值浓度(ng/mL)在低血糖患者中为9,783[4,459-17,976],在无低血糖患者中为1,413[930-1,719](p<0.0001)。低血糖的存在与:较低的年龄和意识水平;和更高的频率的自杀企图,癫痫发作,散瞳,心动过速和5-羟色胺综合征,有创呼吸支持,液体治疗和ICU入院(p<0.05)。
结论:在VLX用药过量病例中检测到低血糖是怀疑患者严重程度的一个容易获得的标记。无论如何,血清浓度时,允许我们确认中毒。
Recent publications relate the presence of hypoglycemia in venlafaxine (VLX) poisoning depending on the dose. Our aim was to analyze the clinical characteristics of patients who presented hypoglycemia induced by VLF overdose.
Retrospective study carried out in the Balearic Islands (2020-2023).
serum concentrations of VLX + O-desmethyl-venlafaxine (O-VLX)>800 ng/mL. The characteristics of patients with and without hypoglycemia were compared.
Twenty-one patients were included, 8 (38.1%) with hypoglycemia. No differences were found in the doses referred to in both groups. Peak concentrations of VLX + O-VLX (ng/mL) were 9,783 [4,459-17,976] in patients with hypoglycemia and 1,413 [930-1,719] in patients without hypoglycemia (p<0.0001). The presence of hypoglycemia was associated with: lower age and level of consciousness; and higher frequency of suicide attempts, seizures, mydriasis, tachycardia and serotonin syndrome, invasive respiratory support, fluid therapy and ICU admission (p<0.05).
The detection of hypoglycemia in a VLX overdose case is a readily available marker to suspect the severity of the patient. In any case, serum concentrations when available allow us to confirm intoxication.