Explanation: Linezolid has weak monoamine-oxidase inhibitor activity meaning it can ⬆️ serotonin levels. It can have additive toxicities with other serotonergic drugs like citalopram & other SSRIs and worst case, could cause serotonin syndrome. But how serious is the risk?

As is often the case in infectious diseases: it depends! 🤔 A recent meta-analysis found rates of serotonin syndrome were < 1% in patients on SSRIs regardless of whether they got linezolid or another antibiotic. Overall, risk of serotonin syndrome is low in this scenario.

Though overall occurrence is low, the FDA recommends to avoid using linezolid with antidepressants. Clinicians should assess number and doses of serotonergic drugs when considering treatment with linezolid. ⬆️ drugs and ⬆️ doses and risk of serotonin syndrome will also ⬆️

Risk vs benefit may differ across individual patients but we should ALWAYS consider drug interactions when making treatment plans 💊