Linezolid-associated serotonin syndrome after concomitant treatment with citalopram and mirtazepine in a critically ill bone marrow transplant recipient.
Linezolid was initially discovered as an antidepressant because of its effect on blocking intracellular metabolism of serotonin, norepinephrine, and other biogenic amines. As time passed, it was realized that linezolid possessed antibacterial activity, and linezolid has been developed and marketed as such. In medicine we are quick to categorize drugs into specific classes as a mechanism to recall indication and use. By classifying linezolid as an antibacterial, it is common to forget about its antidepressant roots. A case report involving linezolid with citalopram and mirtazepine in the precipitation of serotonin syndrome in a critically ill bone marrow transplant patient is described in this article.
DeBellis
Ronald J
RJ
Massachusetts College of Pharmacy and Health Sciences-Worcester, MA, USA. rjdebellis@wor.mcphs.edu
Schaefer
Oren P
OP
Liquori
Michelina
M
Volturo
Gregory A
GA
D000081:Acetamides / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects*; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D015283:Citalopram / Q000009:adverse effects*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D000069349:Linezolid; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D000078785:Mirtazapine; D023303:Oxazolidinones / Q000009:adverse effects*; D011500:Protein Synthesis Inhibitors / Q000009:adverse effects; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D014184:Transplantation, Homologous; D014552:Urinary Tract Infections / Q000209:etiology
D000081:Acetamides; D000900:Anti-Bacterial Agents; D000928:Antidepressive Agents; D015283:Citalopram; D000069349:Linezolid; D008803:Mianserin; D000078785:Mirtazapine; D023303:Oxazolidinones; D011500:Protein Synthesis Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors