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Linezolid-Associated Serotonin Syndrome After Concomitant Treatment With Citalopram and Mirtazepine in a Critically Ill Bone Marrow Transplant Recipient

Massachusetts College of Pharmacy and Health Sciences-Worcester, Worcester, MA, Department of Pulmonary, Allergy and Critical Care Medicine, rjdebellis{at}wor.mcphs.edu

Oren P. Schaefer, MD, FCCP

Department of Pulmonary, Allergy and Critical Care Medicine

Michelina Liquori

Massachusetts College of Pharmacy and Health Sciences-Worcester, Worcester, MA

Gregory A. Volturo, MD, FACEP

Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA

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.

Key Words: linezolid • citalopram • mirtazepine • serotonin syndrome • SSRI • antidepressant • antibiotic

Journal of Intensive Care Medicine, Vol. 20, No. 6, 303-305 (2005)
DOI: 10.1177/0885066605280825


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