Le syndrome sérotoninergique secondaire à l’association du tramadol et des inhibiteurs sélectifs du recaptage de la sérotonine
Bibliographic record
Abstract
Resume Objectifs : Reviser la litterature medicale afin de trouver des cas rapportes de syndrome serotoninergique ou d’effets indesirables lies a l’administration concomitante de tramadol et d’un inhibiteur selectif de la recapture de la serotonine. Determiner la conduite a tenir en presence de cette combinaison. Resume du cas : La patiente, âgee de 45 ans, est connue pour souffrir de depression majeure traitee avec le citalopram. Pour traiter sa douleur aigue due a l’arthrose, on veut entreprendre l’administration de la combinaison tramadol acetaminophene. Discussion : Le tramadol est un analgesique opioide ayant une faible affinite pour le recepteur μ. Il inhibe aussi la recapture de la serotonine et de la noradrenaline et peut alors interagir avec les inhibiteurs selectifs de la recapture de la serotonine. L’association des deux substances peut mener a l’apparition d’un syndrome serotoninergique, mais peu de cas ont ete rapportes dans la litterature pharmacologique. Cela peut s’expliquer entre autres par le fait que le syndrome serotoninergique est une pathologie rarement diagnostiquee. Il est aussi difficile d’etablir un profil de patient qui courrait plus de risque de souffrir de ce syndrome. La combinaison des substances peut aussi causer des convulsions, mais l’incidence rapportee est tres variable selon les etudes et n’est pas toujours significative. Conclusion : L’utilisation concomitante de tramadol et d’un inhibiteur selectif de la recapture de la serotonine reste possible, mais il est primordial de s’assurer que les patients soient en mesure de reconnaitre les signes et symptomes du syndrome serotoninergique. Abstract Objective : To review the medical literature for reported cases of serotonin syndrome or adverse effects related to the concomitant administration of tramadol and a selective serotonin reuptake inhibitor. To determine the course of action in the use of this combination. Case Summary : A 45-year old female patient, known for major depressive disorder and treated with citalopram, suffers osteoarthritis pain, for which the combination of tramadol and acetaminophen is to be used. Discussion : Tramadol is an opioid analgesic with weak affinity for the receptor. It also inhibits serotonin and noradrenaline reuptake and can thus interact with selective serotonin reuptake inhibitors. The association of these two drugs can lead to serotonin syndrome, but few cases have been reported in pharmacological literature. This can be explained by the fact (among others) that serontonin syndrome is a pathology that is rarely diagnosed. It is also difficult to establish a typical profile of patients most at risk from this syndrome. This combination of drugs can also cause seizures, but the reported incidence from studies is quite variable and not always significant. Conclusion : The concomitant use of tramadol and a selective serotonin reuptake inhibitor remains possible, but it is crucial to ensure that patients be able to recognize signs and symptoms of serotonin syndrome. Key words : tramadol; selective serotonin reuptake inhibitor; drug interaction; serotonin syndrome; seizure.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".