Linezolid and Psychiatric Medications
The antibacterial drug Linezolid (Zyvox®) is known to cause serious neurological adverse reactions (serotonin syndrome) when administered with certain psychiatric medications.
What is the Underlying Mechanism?
Answer: Linezolid inhibits the action of monoamine oxidase A (enzyme responsible for breaking down serotonin in the neuron). When linezolid is given to patients taking serotonergic psychiatric medications, high levels of serotonin can build up in the brain, causing serotonin syndrome.
What if Linezolid Needs to be Administered with Serotonergic Medications?
Answer: The serotonergic medication must be immediately stopped and the patient should be closely monitored for emergent symptoms of CNS toxicity for two weeks (five weeks if fluoxetine was taken), OR until 24 hours after the last dose of linezolid, whichever comes first.
How Long to Wait for Treatment with Serotonergic Medication after Linezolid Discontinuation?
Answer: Wait until 24 hours after the last dose of linezolid before starting the antidepressant.
What is the Time to Onset for Serotonin Syndrome Symptoms with this Interaction?
Answer: Ranged from < 24 hours to 3 weeks.
What is the Time to Resolution once Either Medications are Discontinued?
Answer: 1-5 days
Please do post your questions or comments below.
Dr. Harvinder Singh, M.D. (Admin)
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