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AIM To analyze the clinical characteristics and influencing factors of dextromethorphan-induced 5-hydroxytryptamine syndrome （5-HTS）. METHODS Relevant cases of dextromethorphan-induced 5-HTS in PubMed,Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, WanFang database, SinoMed, and VIP database were retrieved,and clinical data were summarized and analyzed. RESULTS A total of 16 cases of 5-HTS were collected, including 11 males and 5 females. Dextromethorphan could cause 5-HTS at both normal and excessive doses, and the majority （88%）of patients were co-administered with other 5-hydroxytryptamine drugs. The onset of 5-HTS occurred between 4 hours and 6 weeks after dextromethorphan administration, with symptoms including myoclonus, tachycardia, and fever. After discontinuation of dextromethorphan and other serotonergic drugs, along with supportive therapy, all patients improved.The mean duration of 5-HTS was 26 hours. Patients treated with cyproheptadine had a shorter duration of 5-HTS, averaging 21.6 hours. CONCLUSION Dextromethorphan-induced 5-HTS most often occurs when used in combination with other serotonergic drugs. It is recommended to strengthen management to reduce the abuse of dextromethorphan and unnecessary co-administration, as well as to improve the ability of physicians and pharmacists to recognize and monitor 5-HTS.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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