2013
DOI: 10.1345/aph.1r604
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Serotonergic and Adrenergic Drug Interactions Associated with Linezolid: A Critical Review and Practical Management Approach

Abstract: Linezolid-associated serotonergic drug interactions occur more commonly than adrenergic interactions. Serotonergic interactions considered probable according to the Horn Drug Interaction Probability Scale do not appear to correlate with drug dosage; time of onset ranges from <1 to 20 days, and effect resolves in <1 to 5 days after discontinuation of offending agents. If coadministration of linezolid and a serotonergic agent cannot be avoided, clinicians should be aware of the symptoms and management of seroton… Show more

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Cited by 47 publications
(26 citation statements)
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“…On the other hand, linezolid therapy has been reported to be associated with myelosuppression, peripheral and optic neuropathy, and lactic acidosis especially with prolonged use [ 35 ]. Further, linezolid-associated serotonergic and adrenergic drug interactions can lead to severe AEs such as hypertensive episodes [ 36 ]. The rates of AEs reported for daptomycin in this retrospective observational study were low, although these may not be compared to AE reporting in a controlled clinical trial [ 23 ].…”
Section: Discussionmentioning
confidence: 99%
“…On the other hand, linezolid therapy has been reported to be associated with myelosuppression, peripheral and optic neuropathy, and lactic acidosis especially with prolonged use [ 35 ]. Further, linezolid-associated serotonergic and adrenergic drug interactions can lead to severe AEs such as hypertensive episodes [ 36 ]. The rates of AEs reported for daptomycin in this retrospective observational study were low, although these may not be compared to AE reporting in a controlled clinical trial [ 23 ].…”
Section: Discussionmentioning
confidence: 99%
“…Most antidepressants take two to eight weeks to demonstrate antidepressant effects, although a placebo effect may be seen prior to this [ 15 , 16 ]. Despite the knowledge that the antidepressant effect will occur at some point, even post-ICU discharge, clinicians may still have reluctance to initiate these drugs in an ICU setting due to side effects like cardiac conduction disturbances, sedative effects, risk of serotonin syndrome, especially with concomitant linezolid antibiotic [ 17 ], potential for increased bleeding [ 18 , 19 ], and other side effects such as dry mouth and blurred vision. Indeed, this intervention did not demonstrate a substantial change in the prevalence of post-ICU depression in our study based on historical cohorts; thus these risks may outweigh any potential benefits of antidepressant initiation in the ICU.…”
Section: Discussionmentioning
confidence: 99%
“…Currently, nonselective, irreversible MAO A/B blockers (phenelzine and tranylcypromine) are very rarely used in clinical psychiatry. However, some clinically used drugs (e.g., the antibiotic linezolid) are mild nonselective MAO blockers and thus they can also evoke this reaction, known as the “cheese effect.” This risk is nonetheless low …”
Section: Drugs With Possible Toxic Effects On Both Cardiomyocytes Andmentioning
confidence: 99%