Linezolid-induced serotonin syndrome

Shouan, Anish; Kumar, Rajeet; Lal, Vivek; Grover, Sandeep

doi:10.4103/ipj.ipj_37_19

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…However, the platelet count returned to normal after treatment with linezolid for 3 days.Factors that can cause thrombocytopenia include leukemia, related autoimmune diseases, drug-and vaccine-induced thrombocytopenia, and patients without associated diseases. 10 According to the criteria for assessing adverse drug reactions, the thrombocytopenia concentration in this case might have been caused by linezolid. It has been reported in the literature that linezolid-induced thrombocytopenia usually occurs within 10-14 days after the initiation of treatment.…”

Section: F I G U R Ementioning

confidence: 95%

Adverse reactions caused by high serum concentration of linezolid: Two case reports and literature review

Liu,

Xiao,

Xiao

et al. 2024

Clinical Case Reports

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Key Clinical MessageLinezolid is a potent oxazolidinone for the treatment of various gram‐positive bacterial infections. However, the drug can cause potential adverse reactions such as thrombocytopenia, hyperlactacidemia and serotonin syndrome, which warrant consideration by the medical team when planning treatment. The existing literature has reported some adverse reactions caused by linezolid, but most of these are based on clinical characteristics and simple treatment measures. Two cases of linezolid overdose resulting in thrombocytopenia, hyperlactacidemia and serotonin syndrome are presented, which were successfully managed with therapeutic drug monitoring. A dose adjustment strategy was adopted to safely and effectively mitigate linezolid‐related adverse events.

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Section: F I G U R Ementioning

confidence: 95%

Adverse reactions caused by high serum concentration of linezolid: Two case reports and literature review

Liu,

Xiao,

Xiao

et al. 2024

Clinical Case Reports

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“…When the syndrome is moderately severe, signs and symptoms include hypertension, hyperthermia, overactive bowel signs, inducible extremity clonus, ocular clonus, agitation, hypervigilance, and pressured speech. The recommended management for this syndrome is the suspension of linezolid with subsequent administration of cyproheptadine and supportive measures [21].…”

Section: Serotonin Syndromementioning

confidence: 99%

“…January-February-5(1): 2374-2378 C inducible extremity clonus, ocular clonus, agitation, hypervigilance, and pressured speech. The recommended management for this syndrome is the suspension of linezolid with subsequent administration of cyproheptadine and supportive measures [21]. Hypoglycemia Linezolid has monoamine oxidase (MAO) inhibitory properties, and MAO inhibitors have been reported to contribute to hypoglycemia.…”

Section: Reaction Synthesismentioning

confidence: 99%

"Myelosuppression and Other Adverse Reactions Caused by Linezolid"

Sanchez

2023

OAJBS

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Background: Linezolid is a synthetic oxazolidinone antimicrobial drug. It is indicated for gram-positive infections and approved for the treatment of other conditions. Myelosuppression is a condition in which bone marrow activity decreases, resulting in fewer red blood cells, white blood cells, and platelets. Pancytopenia is not a disease but a manifestation of other underlying conditions.Methodology: A systematic review was carried out through various databases, such as PubMed, Scielo and ScienceDirect; The search and selection of articles was carried out in indexed journals in English.Results: Linezolid is used as an effective antibiotic against bacteria belonging to the gram-positive group. At high doses up to 1,000 mg/kg/day, reversible myelosuppression occurred. This antibiotic also presents other adverse reactions to take into account such as serotonin syndrome, hypoglycemia, among others. Conclusion:This review offers up-to-date and detailed information on the adverse effects and hematological effects of Linezolid in order to identify its correct use as well as its prognosis.

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“…Symptoms are also used to guide the differential diagnosis of the two syndromes; for example: in NMS, patients may have stiffness, rhabdomyolysis (characterized by muscle fiber destruction), and increased serum creatine phosphokinase (CPK) levels, which should not occur in SS [ 90 ]. However, some SS case reports show that patients present rigidity, sometimes associated with hyperreflexia [ 91 - 94 ] and increased serum CPK levels [ 92 , 95 , 96 ]. In the meta-analysis carried out by Werneke et al (2016), with all cases of SS published in the PubMed databases and Thomson Reuter's Web of Science from 2004 to 2014, they observed that in the 299 cases of SS included in the study, 45.4% (136 cases) had stiffness, and 14% had rhabdomyolysis (42 cases) [ 5 ].…”

Section: Reviewmentioning

confidence: 99%

Serotonin Syndrome: The Role of Pharmacology in Understanding Its Occurrence

Poian,

Chiavegatto

2023

Cureus

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Serotonin syndrome (SS) is a potentially fatal adverse drug reaction characterized by an exaggerated increase in serotonergic activity in the central and peripheral nervous systems. It presents a constellation of signs and symptoms related to behavioral changes, neuromuscular excitability, and autonomic instability. These symptoms can occur in both mild and severe forms. SS can be triggered by the therapeutic use of a drug that increases serotonin (5-HT) availability in the synaptic cleft or by the co-administration of two or more drugs that provide this increase. With the escalating use of antidepressants by the world's population, this adverse reaction may be more recurrent. However, SS is often overlooked by patients or not diagnosed by doctors. This review aims to improve awareness about SS and provide a pharmacological perspective to explain its occurrence. Evidence shows that other neurotransmitters may also be involved with the pathology of SS. Furthermore, SS and neuroleptic malignant syndrome (NMS) seem to be part of the same pathological spectrum, especially in atypical NMS cases. The emergence of the syndrome's symptoms may be closely related to pharmacokinetic and/or pharmacodynamic polymorphisms that lead to an increase in the 5-HT available to or 5-HT signaling by specific receptors, thus constituting an important area for future investigations.

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Linezolid-induced serotonin syndrome

Cited by 6 publications

References 26 publications

Adverse reactions caused by high serum concentration of linezolid: Two case reports and literature review

Adverse reactions caused by high serum concentration of linezolid: Two case reports and literature review

"Myelosuppression and Other Adverse Reactions Caused by Linezolid"

Serotonin Syndrome: The Role of Pharmacology in Understanding Its Occurrence

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