Pharmacy Times September 2018


Drug Interactions: Insights and Observations


Linezolid and Serotonin Syndrome


John R. Horn, PharmD, FCCP, and Philip Hansten, PharmD


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2. Isbister GK et al. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust. 2007;187:3610365.

3. Horn JR, Hansten PD, Chan L-N. Proposal for a New Tool to Evaluate Drug Interaction Cases. Ann Pharmacother. 2007;41:674-680.

4. Ma J, Zhu P, Tu G, Li X. Serotonin syndrome under combination of linezolid and low-dose citalopram with amiodarone. Psych Clin Neurosci. 2013;67:457-459.

5. Samartzis L, Savvari P, Kontogiannis S, Simopoulos S. Linezolid is associated with serotonin syndrome in a patient receiving amitriptyline, and fentanyl: a case report and review of the literature. Case Rep Psychiatry. 2013;2013:617251. doi: 10.1155/2013/617251.

6. Mazhar F, Akram S, Haider N, Ahmed R. Overlapping of serotonin syndrome with neuroleptic malignant syndrome due to linezolid-fluoxetine and olanzapine-metoclopramide interactions: a case report of two serious adverse drug effects caused by medication reconciliation failure on hospital admission. Case Rep Medicine. 2016;

7. Kulkarni RR. Kulkarni PR. Linezolid-induced near-fatal serotonin syndrome during escitalopram therapy: case report and review of literature. Indian J Psychol Med. 2013;35:413416.

8. Thomas CR, Rosenberg M, Blythe V. Meyer WJ 3rd. Serotonin syndrome and linezolid. J Am Acad Child Adolesc Psychiatry. 2004;43:790.

9.Strouse TB, Kerrihard TN, Forscher CA, Zakowski P. Serotonin syndrome precipitated by linezolid in a medically ill patient on duloxetine. J Clin Psychopharmacol. 2006;26:681-3.

10. Shah ND, Jain AB. Serotonin syndrome presenting as pulmonary edema. Indian J Pharmacol. 2016; 48:9395.

11. Ramsey TD, Lau TTY Ensom MHH. Serotonergic and adrenergic drug interactions associated with linezolid: a critical review and practical management approach. Ann Pharmacother. 2013;47:543-560.

12. Lodise TP, Patel N, Rivera A, Tristani L, Lazariu V, Vandewall H, et al. Comparative evaluation of serotonin toxicity among Veterans Affairs patients receiving linezolid and vancomycin. Antimicrob Agents Chemother. 2013;57:5901-11. doi: 10.1128/AAC.00921-13.

13. Karkow DC, Kauer JF, Ernst EJ. Incidence of serotonin syndrome with combined use of linezolid and serotonin reuptake inhibitors compared with linezolid monotherapy. J Clin Psychopharmacol. 2017;37:518-523.

14. Deardorff OG, Khan T, Kulkarni G, Doisy R, Loehr C. Serotonin syndrome: prophylactic treatment with cyproheptadine. Prim Care Companion CNS Disord. 2016;18 doi: 10.4088/PCC.16br01966.