Central Anticholinergic Syndrome Due to Cyproheptadine Overdose in a Child: A Case Report and Literature Review

Cyproheptadine過量在兒童引發中樞抗膽鹼症候群：一病例報告

李春銘(Chuen-Ming Lee) ； 巫宏明(Hung-Ming Wu) ； 關美玉(Mei-Yu Kuan) ； 洪芝怡(Chih-I Hung) ； 遲景上(Ching-Shiang Chi) ； 范洪春(Hueng-Chuen Fan)

《童綜合醫學雜誌》 15卷1期 (2021/06) Pp. 40-44

https://doi.org/10.3966/207135922021061501008

摘要

Central anticholinergic syndrome is common and its clinical manifestations include agitation, confusion, dry mouth, tachycardia, and hypertension. Cyproheptadine is a first-generation antihistamine with anti-serotonergic and anti-cholinergic effects and a common medication used for treating various allergic symptoms. The pharmaceutical technology has been improving the taste of the pharmaceutical formulations, including the syrups, without affecting their pharmacological effects, leading, however, to a risk of overdose, especially in children. This study reports a clinical case of a girl with a typical central anticholinergic syndrome due to taking excessive amounts of cyproheptadine. A high index of suspicion, anamnesis, and an astute physical examination are the main key to the most accurate diagnosis and the appropriate treatment.

關鍵字

Anticholinergic syndrome ； Cyproheptadine ； overdose

並列摘要

中樞抗膽鹼症候群（central anticholinergic syndrome）並不罕見，臨床表現為躁動，神智不清，口乾，心博過速過速和高血壓。Cyproheptadine是治療各種過敏症狀的常用藥物，是第一代抗組胺藥，具有額外的抗5-羥色胺和抗膽鹼作用。由於先進的製藥技術使此具苦味的化合物變成了美味的糖漿而不影響其藥理作用，特別是在兒童更會有增加藥物過量的風險。因此，我們報告一位女童，因為服用過量的cyproheptadine而表現典型的中樞抗膽鹼症候群。臨床高度懷疑，小心的病史詢問和仔細身體檢查是發現此病和適當治療的主要關鍵。

並列關鍵字

中樞抗膽鹼症候群 ； cyproheptadine ； 藥物過量