Serotonin Syndrome: Prophylactic Treatment With Cyproheptadine

Abstract

Despite the numerous advantages of linezolid therapy, one disadvantage continuing to hinder its use is the risk of serotonin syndrome when coadministered with other serotonergic agents. Developing a better understanding of serotonin syndrome is essential for the prevention and management of this potentially life-threatening condition. This report describes a patient with schizophrenia, depression, and severe, acute osteomyelitis. The patient was taking multiple serotonergic agents and required the use of linezolid without the possibility of a sufficient washout period. The severity of the patient's condition in conjunction with increased risk for serotonin syndrome warranted prophylactic treatment with cyproheptadine. The complex pathophysiology of prophylactic treatment of serotonin syndrome with cyproheptadine is worthy of discussion.