Serotonin Toxicity Associated with Concomitant Use of Linezolid

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

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.

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