Serotonin syndrome ciprofloxacin

Venlafaxine. An 85-year-old man taking venlafaxine 150 mg daily was prescribed ciprofloxacin, rifampicin and linezolid 600 mg twice daily for a hip prosthesis infection. After 20 days he was found to be confused and disorientated, and 4 days later he was also drowsy, and suffering myoclonic jerks. Linezolid and venlafaxine were stopped and the symptoms resolved over 2 days. However, another case report describes a 7-year-old boy treated with venlafaxine and methylphenidate who was prescribed linezolid for osteomyelitis. He was given all three drugs (doses not stated) for several days without any alterations in vital signs or evidence of the serotonin syndrome. ... 

Ciprofloxacin, enoxacin and quinidine are predicted to raise du-ioxetine levels. Duloxetine is predicted to raise the ieveis of fiecai-nide and thioridazine. Due to the theoreticai risk of serotonin syndrome, the manufacturers of duioxetine recommend caution... 

Venlafaxine Inhibition of CYP3A4 by ciprofloxacin in a 61-year-old man taking methadone and venlafaxine was thought to have caused serotonin syndrome after 2 weeks therapy [54" ]. 

Lee J, Franz L, Goforth HW. Serotonin syndrome in a chronic-pain patient receiving concurrent methadone, ciprofloxacin, and venlafaxine. Psychosomatics 2009 50 (6) 638-9. 

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