Linezolid and Serotonin Syndrome -- Lavery et al. 42 (5): 432 -- Psychosomatics Received March 21, 2001; accepted March 29, 2001. From Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Norfolk, Virginia 23507. Address correspondence and reprint requests to Dr. Pushkin, Associate Professor of Clinical Psychiatry, Director Consultation Liaison Psychiatry, EVMS; E-mail address: Mr. S., a 45-year-old white male with a long history of probable schizoaffective disorder and three previous suicide attempts was admitted to the trauma service after an acute suicide attempt. The most recent attempt involved jumping out of a two-story building resulting in a T6-level spinal cord injury and paraplegia. The consultation-liaison psychiatry service was consulted on admission. Psychiatric consultation assessment revealed an acutely depressed patient complaining of depressive thought content as well as psychosis. Pharmacotherapy was initiated with sertraline and risperidone and titrated to 200 mg qd and 1 mg bid, respectively. Mr. S. subsequently underwent T4 T6 fixation and spent 2 months on the rehabilitation unit. When medically stable, he was transferred to the psychiatric ward, where his medications were adjusted. Bupropion up to the dosage of 75 mg bid was added owing to partial treatment response and trazodone 50 mg qhs was added for sleep disturbance. Mr. S. continued to exhibit refractory depressive symptoms after these medication adjustments. Therefore, lithium carbonate 300 mg bid was added.
