Fluoxetine造成Phenytoin中毒：病例報告與文獻回顧

Phenytoin Intoxication Induced by Fluoxetine: A Case Report and Review of Literature

劉健群(Chien-Chun Liu) ； 諶立中(Lih-Jong Shen)

《Journal of Medical Sciences》 21卷S期 (2001/11) Pp. 107-112

摘要

選擇性血清素再吸收抑制劑對於焦慮或憂鬱疾病經證實有著良好的治療效果，然而服用此類藥物的病患也曾出現嚴重的藥物交互作用。本篇報告一位二十四歲男性器質性精神病合併癲癇的個案，使用抗精神藥物與抗痙攣藥物多年，並未出現藥物中毒現象，因強迫症狀而合併使用Fluoxetine後，逐漸出現步態不穩、頭暈、虛弱與定向感差等症狀，經檢查藥物濃度，發現Phenytoin血漿濃度大幅增加，導致中毒症狀產生。同時我們對Fluoxetine在Cytochrome P450系統的抑制作用所產生藥物交互作用的文章做一回顧與整理，期望在對Fluoxetine可能產生的藥物交互作用更瞭解的同時，能避免它們的併用可能帶來的傷害。

關鍵字

百憂解 ； 交互作用 ； Phenytoin中毒

並列摘要

The therapeutic efficacy of SSRIs to depression and anxiety disorders has been demonstrated in clinical practice. However, potential serious drug interactions have been reported in patients taking these medications. In this paper, we present a case of 24-year-old male with organic mental disorder and epilepsy, who had taken the anti psychotics and antiepileptics without durg intoxication for years. After taking the Fluoxetine for his persistent compulsive behavior, the symptoms of unstable gait, dizziness, and disorientation were noted. We found the plasma concentration of phenytoin increased massively and the intoxication occurred. We also review the drug interactions caused by the inhibitive effect of Fluoxetine on cytochrome P450 system. We hope the possible damage can be prevented by knowing more about the possible drug interactions.

並列關鍵字

fluoxetine ； interaction ； phenytoin intoxication