Serotonin syndrome after concomitant treatment with linezolid and citalopram

Area of Science:

• Pharmacology
• Infectious Diseases
• Critical Care Medicine

Background:

• Linezolid is a synthetic antimicrobial effective against methicillin-resistant Staphylococcus aureus (MRSA).
• Previous reports suggest potential for serotonin syndrome with linezolid and selective serotonin reuptake inhibitors (SSRIs).

Purpose of the Study:

• To report a fatal case of severe adverse events associated with long-term linezolid therapy.
• To highlight the potential risks of combining linezolid with citalopram, an SSRI.

Main Methods:

• Case report detailing a patient's clinical course.
• Review of patient's medical history and concomitant medications.

Main Results:

• The patient developed thrombocytopenia, serotonin syndrome, and lactic acidosis.
• These severe adverse events occurred during long-term linezolid therapy in conjunction with citalopram.
• The patient ultimately died.

Conclusions:

• Long-term linezolid use, especially with SSRIs like citalopram, poses significant risks.
• Clinicians should be vigilant for potential drug interactions and severe adverse events, including serotonin syndrome, thrombocytopenia, and lactic acidosis.
• This case underscores the need for careful patient monitoring during linezolid treatment.