Association Between Selective Serotonin-Reuptake Inhibitors, Second-Generation Antipsychotics, and Neuroleptic Malignant Syndrome
Association Between Selective Serotonin-Reuptake Inhibitors, Second-Generation Antipsychotics, and Neuroleptic Malignant Syndrome
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选择性血清素再摄取抑制剂、第二代抗精神病药物与抗精神病药恶性综合征之间的关联
DOI：
10.1345/aph.1l066
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发表时间：
2008
影响因子：
2.9
通讯作者：
Debra L. Stevens
中科院分区：
文献类型：
--
作者：
Debra L. Stevens
目的回顾与选择性5-羟色胺再摄取抑制剂(SSRIs)和第二代抗精神病药物相关的抗精神病药恶性综合征(NMS)的文献报道。资料来源：资料来源于MEDLINE英文文献检索(1950-2008年5月)。手工检索与第二代抗精神病药物相关的NMS的所有已发表病例的MEDLINE(仅英文)。研究选择和资料提炼：纳入所有获得的报告中的相关信息，特别强调患者的年龄、性别、涉及的第二代抗精神病药物、涉及SSRI或其他抗抑郁药、与用药变化有关的NMS症状出现的时间、给予的治疗以及反应的结果。资料综合：每一种第二代抗精神病药物都有NMS的报道。目前尚不清楚与其他药物联合治疗是否会通过药效学或药代动力学机制或两者兼而有之增加NMS的风险，提示与SSRIs联合使用增加NMS风险的药效学机制是5-羟色胺对多巴胺释放的影响。5-羟色胺进一步抑制多巴胺的释放，从而可能恶化由抗精神病药物引起的低多巴胺状态。药代动力学因素也可能通过增加抗精神病药物的浓度在一些涉及SSRI的NMS病例中发挥作用。对病例报告的检查似乎发现，至少在一些赌场，在现有的抗精神病药物治疗的基础上增加SSRI存在时间关系。结论：SSRIs的使用可能与接受第二代抗精神病药物治疗的软管发生NMS的风险增加有关。临床医生应密切监测患者NMS的潜在发展。
Objective To review the published reports of neuroleptic malignant syndrome (NMS) associated with the use of selective serotonin-reuptake inhibitors (SSRIs) and second-generation antipsychotics. Data Source: Information was selected from a MEDLINE search of English-language literature (1950–May 2008). Manual search of all published cases indexed in MEDLINE (English language only) of NMS associated with second-generation antipsychotics was also performed. Study Selection And Data Extraction: Pertinent information from all reports obtained was included, with specific emphasis on patient age, sex, second-generation antipsychotic involved, SSRI or other antidepressant involved, time of onset of NMS symptoms in relation to medication changes, treatment administered, and outcome of the reaction. Data Synthesis: NMS has been reported with every second-generation antipsychotic agent. It is unclear whether concomitant therapy with other agents may increase the risk of NMS development via pharmacodynamic or pharmacokinetic mechanisms or both, The suggested pharmacodynamic mechanism for increased risk of NMS with concomitant use of SSRIs is the effect of serotonin on dopamine release. Serotonin further inhibits dopamine release and thereby may worsen a hypodopaminergic state induced by antipsychotics. Pharmacokinetic factors may also play a role in some NMS cases involving an SSRI by increasing antipsychotic concentrations. An examination of case reports seems to indícale that at least in some casos, a temporal relationship exists with the addition of an SSRI to existing antipsychotic therapy. Conclusions: The use of SSRIs may be associated with an increased risk of NMS development in (hose receiving second-generation antipsychotics. Clinicians should closely monitor patients for the potential development of NMS.
大型精神病医院抗精神病药恶性综合征的频率和表现。
DOI：
10.1176/ajp.143.10.1227
发表时间：
1986
期刊：
The American journal of psychiatry
影响因子：
--
作者：
PopeJr,HG;KeckJr,PE;McElroy,SL
通讯作者：
McElroy,SL