目的：Meperidine 為弱效止痛藥品與其他血清素類藥物併用可抑制血清素再回收而誘發血清素症候群 (serotonin syndrome, SS)，此致命之不良反應最常因單一或多種藥品併用而導致。為降低meperidine 引發血清素症候群風險，針對某區域教學醫院meperidine 併用血清素類藥物之處方型態進行分析與探討其相關危險因子。
方法：以回溯性觀察方式，蒐集某區域教學醫院於2013 年1 月至2015 年12 月期間同時使用meperidine 與血清素類藥品個案的性別、年齡、使用數量及藥物種類，進行易引發血清素毒性的藥品類別併用比例分析。
結果：研究期間使用meperidine 之11,594 之病人中，與血清素類藥物併用者共4,127 位， 分別為2013 年1,491 位 (35.6%)、2014 年1,398 位 (35.3%) 及2015年1,238 位 (35.9%)。併用血清素類藥品比例最高為止痛藥，其次為精神科用藥、dextromethophan、單胺氧化酶抑制劑及carbamazepine。
結論：本研究顯示meperidine 與血清素類藥品併用比例中，止痛藥物及複方製劑之使用最多。對於跨科就醫、多重用藥或長期使用含血清素類複方製劑之病人發生血清素症候群風險實不容小覷。因此，對於跨科就醫的處方審核應更加謹慎並期望能藉由醫囑系統提示管控，以期降低meperidine 誘發血清素毒性反應的潛在風險，確保病人用藥安全。

Objective: Meperidine is a weak analgesic agent and may lead to toxic serotonin syndromes (SS) when combined with other serotonergic agents. The fatal syndrome can be induced by concurrent use several serotonergic agents. In order to reduce the risk of SS, we investigate the prescription pattern of meperidine and serotonergic agents combination use in our hospital.
Methods: This study is a retrospective survey about patients who received meperidine and serotonergic agents combination use in a regional teaching hospital from 1st January 2013 to 31st December 2015.We analyze age, sex, amount, classification of serotonergic drugs, and all concurrent medications which potentially causing serotonin syndrome.
Results: Over the 3-year study period, there were 11,594 patients received meperidine, and 4,127 of them were treated with both meperidine and a serotonergic agent. The distribution of this population is: 1,491 (35.6%), 1,398 (35.3%), 1,238 (35.9%) in 2013, 2014, and 2015 respectively. As the most frequent medication combined with meperidine are: analgesic agents, anti-psychotic agents, dextromethophan, MAO inhibitors, and carbamazepine.
Conclusions: Analgesics and combination products are more trending to concurrent use with meperidine. The possibilities of poly-pharmacy, drug interactions between individual prescriptions from different specialties, adding meperidine on a long-term serotonergic agent user, will cause the potential risk of the occurrence of serotonin syndrome. Therefore, system alert with drug interaction checking function between different prescriptions, medication appropriateness reviewing by pharmacists, both are active ways to lowering the risk of serotonin toxicity and prevent the occurrence of potential drug problem to ensure the medication safety.