Linezolid-associated serotonin syndrome: what we can learn from cases reported so far

J Antimicrob Chemother. 2005 Dec;56(6):1176-8. doi: 10.1093/jac/dki368. Epub 2005 Oct 13.

Abstract

Objectives: To study the characteristics of the linezolid-associated serotonin syndrome cases.

Methods: Database search for linezolid-associated serotonin syndrome.

Results: Twelve cases were found. The mean age of patients was 52.8 years. All patients received linezolid concomitantly with selective serotonin re-uptake inhibitor drugs (SSRID). The onset of syndrome was 9.5 days after linezolid introduction and was directly correlated to patients' age (P = 0.024). The symptoms resolved in 2.9 days. Citalopram was associated with a delayed resolution (P = 0.018). A trend was observed towards longer resolution time the longer the half-life of the interacting drug (P = 0.096).

Conclusions: Patients are at risk when receiving SSRID concomitant with linezolid. The syndrome onset could be delayed in older patients. The resolution could be delayed when citalopram is involved in the syndrome.

MeSH terms

  • Acetamides / administration & dosage
  • Acetamides / adverse effects*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects*
  • Bacterial Infections / drug therapy
  • Child, Preschool
  • Citalopram / adverse effects
  • Female
  • Half-Life
  • Humans
  • Linezolid
  • Male
  • Middle Aged
  • Oxazolidinones / administration & dosage
  • Oxazolidinones / adverse effects*
  • Serotonin Syndrome / etiology*
  • Serotonin Uptake Inhibitors / administration & dosage

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Oxazolidinones
  • Serotonin Uptake Inhibitors
  • Citalopram
  • Linezolid