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As you know, linezolid is an oxazolidinone antibiotic used widely in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) infection. Along with its antibiotic effect against gram positive cocci, it has psychotropic property with antidepressant effects through mild reversible non-selective inhibition of monoamine oxidase (MAO) enzymes that metabolize the neurotransmitters like serotonin.1 Serotonin syndrome (SS) or serotonin toxicity occurs due to increased levels of circulating serotonin in the central and peripheral nervous system; and is characterized by mental and neuromuscular abnormalities, and autonomic hyperactivity.2,3 Linezolid administration in patients taking serotonin agonist holds a mild risk of developing SS. However, the patient being reported was not on any serotonin agonists, and yet developed SS with linezolid.

Linezolid induced Serotonin Syndrome in the absence of serotonergic agent