CriticalSSRI (selective serotonin reuptake inhibitor)×Oxazolidinone antibiotic
Updated · Methodology
Mechanism
Citalopram (SSRI) raises synaptic serotonin. Linezolid reversibly inhibits MAO. Co-administration sharply amplifies serotonergic transmission. The FDA carries a boxed warning.
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia, dilated pupils. Autonomic features: profuse sweating, tachycardia, hypertension, fever above 38.5 °C. Severe cases progress to seizures, rhabdomyolysis, disseminated intravascular coagulation, and death. First signs appear within hours of concurrent dosing.
Management
The combination is not prescribed. Stop citalopram at least 2 weeks before linezolid. Alternative antibiotics: vancomycin, daptomycin, ceftaroline by susceptibility.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Zyvox (linezolid) boxed warning - MAO/serotonergic (2010)– ; DailyMed setid 6e70e63b-bfd5-478d-a8ee-8ba22c9efabd
- AEMPS: Ficha técnica: Citalopram (nº registro 65994), sección 4.5 (2025)– AEMPS, CIMA, nº registro 65994, sección 4.5