Linezolid should be used with caution with which drug class due to risk of serotonin syndrome?

• A. SSRIs
• B. Beta blockers
• C. NSAIDs
• D. Antacids

Answer: (A)

Linezolid has monoamine oxidase inhibiting activity, which can increase serotonin levels in the brain. When it is used with drugs that boost serotonin, such as selective serotonin reuptake inhibitors, the risk of serotonin syndrome rises. Serotonin syndrome is a potentially serious condition that can present with agitation, confusion, tremor, clonus, hyperreflexia, fever, and autonomic instability, usually appearing soon after the combination is started.

Other choices don’t carry the same risk because beta blockers, NSAIDs, and antacids do not substantially elevate serotonin levels. The key point is that SSRIs are serotonergic agents, so they interact with linezolid’s MAOI activity to raise the chance of serotonin syndrome. In practice, clinicians may avoid the combination or plan a washout period or dose adjustments and closely monitor for signs of serotonin syndrome.