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Interactions with Linezolid: Serotonin Syndrome Possible


In addition to its effectiveness for treating serious infections of resistant gram-positive infections, linezolid (Zyvox—Pharmacia) has been shown in vitro to inhibit monoamine oxidase (MAO). In patients with underlying disorders that place them at high risk (i.e., patients with cardiovascular, hepatic, and/or pulmonary disease), this secondary effect of linezolid appears to be producing serious interactions with selective serotonin reuptake inhibitors (SSRIs), causing serotonin syndrome and potentiating hematologic toxicity of the anti-infective agent.


Hachem RY et al. Myelosuppression and serotonin syndrome associated with concurrent use of linezolid and selective serotonin reuptake inhibitors in bone marrow transplant recipients. Clin Infect Dis. 2003;37:e8–e11.

Bernard L et al. Serotonin syndrome after concomitant treatment with linezolid and citalopram. Clin Infect Dis. 2003;36:1197.

Wigen CL, Goetz MB. Serotonin syndrome and linezolid. Clin Infect Dis. 2002;34:1651–2.