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1例91岁男性冠心病患者,近1年服用文拉法辛150 mg/d治疗抑郁/焦虑症。因精神症状加重拟停用文拉法辛换用他药,遂将文拉法辛减为75 mg/d,1 d后停用。次日晨患者意识突然丧失,10 min后恢复,血压50/30 mm Hg(1 mm Hg=0.133kPa)。给予多巴胺治疗。第2天患者心电图示急性心肌梗死;诊断为文拉法辛撤药综合征。给予阿司匹林、氯吡格雷、硝酸甘油及喹硫平等治疗,之后,患者明显好转,住院20 d出院。
A 91-year-old man with coronary heart disease, nearly 1 year of venlafaxine 150 mg / d treatment of depression / anxiety. Venlafaxine was discontinued for psychotropic symptoms due to discontinuation of venlafaxine, then venlafaxine was reduced to 75 mg / d and discontinued after 1 d. The patient’s consciousness was abruptly lost the next morning and resumed after 10 minutes with a blood pressure of 50/30 mm Hg (1 mm Hg = 0.133 kPa). Give dopamine treatment. On the second day, the patient’s ECG showed acute myocardial infarction; diagnosis of venlafaxine withdrawal syndrome. Given aspirin, clopidogrel, nitroglycerin and quetiapine equal treatment, after the patient was significantly improved, discharged 20 days hospitalization.