فاکتورهای دموگرافیک، تظاهرات بالینی و عاقبت درمانی در بیماران مسموم با داروهای مهارکننده‌ی بازجذب انتخابی سروتونین

نوع مقاله : Original Article(s)

نویسندگان

1 استاد، گروه سم‌شناسی بالینی، مرکز تحقیقات سم‌شناسی بالینی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 پزشک عمومی، گروه سم‌شناسی بالینی، مرکز تحقیقات سم‌شناسی بالینی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار، گروه پزشکی اجتماعی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشیار، گروه سم‌شناسی بالینی، مرکز تحقیقات سم‌شناسی بالینی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقاله پژوهشی




مقدمه: داروهای مهارکننده‌های بازجذب انتخابی سروتونین (SSRIs) یکی از شایع‌ترین دسته‌های دارویی هستند که منجر به مسمومیت می ‌شوند. هدف این مطالعه، بررسی مشخصات دموگرافیک، علایم بالینی و عاقبت درمانی بیماران مسموم با SSRI می‌باشد.
روش‌ها: در این مطالعه‌ی مقطعی گذشته‌نگر، از داده‌های بیماران مسموم با SSRIs که در سال 1398 در بخش مسمومین بیمارستان خورشید دانشگاه علوم پزشکی اصفهان بستری شده بودند، اطلاعات دموگرافیک، توکسیکولوژیک و کلینیکال بدو ورود مورد بررسی قرار گرفت.
یافته‌ها: از 6631 بیمار بستری با تشخیص مسمومیت، 66 بیمار (1 درصد) به دلیل مسمومیت با SSRI در بیمارستان بستری شده بودند. شایع‌ترین داروی مسمومیت، سیتالوپرام (39/4 درصد) و بعد از آن سرترالین (37/9 درصد) بود. میانگین سنی بیماران 25/9 سال و اغلب آن‌ها را زنان (90/9 درصد) و با مسمومیت عمدی
(78/8 درصد) تشکیل می‌دادند. تهوع و استفراغ (43/9 درصد) شایع‌ترین علامت بالینی بودند. 20 بیمار (30/3 درصد) سینوس تاکی‌کاردی داشتند که اکثراً مربوط به سرترالین بود (26/7 درصد). 2 بیمار (3 درصد) با سیتالوپرام دچار تشنج شدند و تنها در یک بیمار سمیت سروتونین با سیتالوپرام رخ داد. طول مدت بستری در بیماران 1/54 ± 0/56 روز بود. هیچ کدام از متغیرهای مورد بررسی عامل پیش‌گویی‌کننده‌ی طول مدت بستری نبودند.
نتیجه‌گیری: در این مطالعه، شایع‌ترین SSRIs عامل مسمومیت، سیتالوپرام و پس از آن سرترالین بود. همه‌ی بیماران با اقدامات حمایتی و با بهبودی کامل مرخص شدند، اما جهت ارزیابی اثرات مسمومیت این داروها نیاز به مطالعات در بازه‌های زمانی طولانی‌تر و با حجم نمونه‌ی بیشتر وجود دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Demographic Factors, Clinical Manifestations and Treatment Outcomes in Patients Poisoned with Selective Serotonin Reuptake Inhibitor Drugs

نویسندگان [English]

  • Nastaran Eizadi-Mood 1
  • Narges Khademi 2
  • Shadi Haddad 2
  • maryam Ghasemi aliabadi 2
  • Parastoo Golshiri 3
  • Rokhsareh Meamar 4
1 Professor, Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 General Physician, Department of Clinical Toxicology, School of Medicine, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Community and Preventive Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Associate Professor, Department of Clinical Toxicology, School of Medicine, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Selective serotonin reuptake inhibitors (SSRIs) are one of the most common drug classes leading to toxicity. The aim of this study was to evaluate the demographic characteristics, clinical symptoms, and treatment outcome of patients with SSRI poisoning.
Methods: In this retrospective cross-sectional study, demographic, toxicological and clinical data were analyzed from the data of patients poisoned with SSRIs in 2019 in the referral poisoning emergency center of Khorshid Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran.
Findings: Out of the 6631 poisoned emergency patients, 66 patients (1%) were hospitalized due to SSRI poisonings. The most common poisoning drug was citalopram (39.4%) followed by sertraline (37.9%). The mean age of patients was 25.9 years and most of them were women (90.9%) with intentional poisoning (78.8%). Nausea and vomiting (43.9%) were the most common clinical symptoms. 20 patients (30.3%) had sinus tachycardia, which was mostly related to sertraline (26.7%). Two patients (3%) had seizures with citalopram and only one patient had serotonin toxicity following citalopram ingestion. The mean length of hospital stay was 0.56±1.54. None of the factors investigated was a good predictor for the duration of hospital stay duration.
Conclusion: In this study, the most common SSRIs causing poisoning were citalopram, followed by sertraline. All patients were discharged with supportive measures and with complete recovery, but in order to evaluate the effects of poisoning of these drugs, there is a need for studies in longer periods of time and with larger sample size.

کلیدواژه‌ها [English]

  • SSRI
  • Demography
  • Poisoning
  • Critical care outcomes
  • Drug-related side effects and adverse reactions
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