使用5-羟色胺再摄取抑制剂150例病人的不良反应分析

An analysis of adverse reactions of one hundred and fifty patients treated with SSRIs

目的 :了解选择性 5 羟色胺再摄取抑制剂(SSRIs)氟西汀、舍曲林、帕罗西汀的不良反应特点 ,增强对 5 羟色胺 (5 HT)综合征的认识。方法 :用自制不良反应调查表对 15 0例使用上述 3药的病人发生的药物不良反应进行调查。结果 :发现有 7例出现 5 HT综合征 ,共同表现意识模糊、肌张力增高、反应迟钝、主动性减退、震颤、遗忘 ,停药才消失 ,其中 1例曾误诊为老年性痴呆 ;另 143例中失眠、头痛(头晕 )、烦躁等不良反应 ,氟西汀组高于其他 2组 ,余无差异 ,此类不良反应能自行减轻或消失。结论 :应提高对SSRIs药物不良反应的认识 ,对 5

AIM: To study the characteristic of adverse reactions of SSRIs such as fluoxetine, sertraline, paroxetine and to enhance the realization of the serotonin syndrome. METHODS: The adverse reactions of one hundred and fifty patients treated with SSRIs were investigated by the adverse reactions rating scale created by the author. RESULTS: Seven patients were found to suffer from the serotonin syndrome, including confusion, high muscle tension, slow response, passive action, tremor, amnesia. These symptoms vanished only after stopping using SSRIs. One of these patients was misdiagnosed as Alzheimer disease. These adverse reactions such as gastrointestinal reaction, insomnia, anxiety, agitation, headache/dizziness, sweat, incoordination, nervousness were found in the remained one hundred and forty-three patients. There were more seriouse insomnia, headache/dizziness and anxiety in fluxetine group than those in the other groups. No other differences were found among those drugs. The adverse reactions relieved or vanished gradually. CONCLUSION: We should pay more attention to the adverse reactions of SSRIs, espacially to the identification between the serotonin sydrome and intensified depression.