Lorenz Raymond A, Vandenberg Amy M, Canepa Elizabeth A
Auburn University Harrison School of Pharmacy, Mobile, Alabama, USA.
Int J Psychiatry Med. 2008;38(1):81-90. doi: 10.2190/PM.38.1.h.
To report the results from a retrospective chart review looking at the combination of linezolid and serotonergic antidepressants and to report two cases of serotonin syndrome which were identified at our hospital.
During the retrospective chart review one case of serotonin syndrome was identified. A 65-year-old female was receiving escitalopram for the treatment of depression prior to admission. Linezolid therapy was initiated on admission and two days later the patient had a tonic-clonic seizure. Escitalopram was discontinued and the patient did not have any further seizure activity. In a second case, a 37-year-old male was receiving citalopram during hospitalization and was started on concomitant linezolid. The patient had myoclonus and was observed to be tremulous throughout therapy with linezolid. Ten days after discontinuation of linezolid the patient continued to have symptoms until the withdrawal of citalopram. The Naranjo probability scale scores the first case as possibly related and the second case as probably related to the combination.
It has been well documented in the literature that the combination of linezolid and serotonergic antidepressants may cause serotonin syndrome. In this retrospective chart review only one patient of 53 (1.8%) had symptoms highly suggestive of serotonin syndrome. A second patient continued to have symptoms of serotonin syndrome even after withdrawal of linezolid.
This retrospective review and subsequent case reports confirm the rare, but serious, potential of serotonin syndrome associated with the combination of linezolid and serotonergic antidepressants.
报告一项回顾性病历审查的结果，该审查关注利奈唑胺与血清素能抗抑郁药的联合使用情况，并报告我院确诊的两例血清素综合征病例。
在回顾性病历审查中确诊了一例血清素综合征病例。一名65岁女性在入院前接受艾司西酞普兰治疗抑郁症。入院时开始使用利奈唑胺治疗，两天后患者出现强直阵挛性发作。停用艾司西酞普兰后，患者未再出现发作活动。在第二例中，一名37岁男性在住院期间接受西酞普兰治疗，并同时开始使用利奈唑胺。患者出现肌阵挛，在整个利奈唑胺治疗期间均有震颤。停用利奈唑胺10天后，患者症状持续存在，直至停用西酞普兰。根据Naranjo概率量表评分，第一例可能与联合用药有关，第二例很可能与联合用药有关。
文献中已有充分记载，利奈唑胺与血清素能抗抑郁药联合使用可能导致血清素综合征。在这项回顾性病历审查中，53例患者中只有1例（1.8%）出现高度提示血清素综合征的症状。第二例患者即使在停用利奈唑胺后仍有血清素综合征症状。
这项回顾性审查及后续病例报告证实，利奈唑胺与血清素能抗抑郁药联合使用存在导致血清素综合征的罕见但严重的可能性。
