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Peripheral neuropathy, serotonin syndrome and optic neuropathy: 16 case reports In a retrospective study of patients with multidrug-resistant tuberculosis (MDR-TB) treated between January 2011 and December 2016, 16 patients (15 male and 1 female) were described [including 14 patients aged 20–48 years, exact ages of 2 patients not stated], who developed peripheral neuropathy, serotonin syndrome or optic neuropathy during treatment with linezolid for MDR-TB. Of which, one male patient developed serotonin syndrome following the concomitant administration of linezolid with amitriptyline, clonazepam and loxapine [routes not stated; not all dosages, times to reactions onsets and outcomes stated]. All 16 patients were diagnosed with MDR-TB; of which, two patients also had a history of diabetes mellitus, high BP, hepatitis-C virus infection or lung lobectomy. Subsequently, all the patients started receiving treatment with linezolid 600mg once daily. Two patients concomitantly received various other drugs. Out of the 16 patients, 14 patients developed optic neuropathy. Thirteen of these 14 patients developed optic neuropathy after 0–17.9 months of linezolid treatment. The remaining 2 patients developed peripheral neuropathy, 5–11 months after the initiation of linezolid therapy. Hence, the linezolid therapy was stopped for the 14 patients with optic neuropathy. Subsequently, the optic neuropathy resolved in 10 patients, but persisted in 4 patients. In the 2 patients, who developed peripheral neuropathy, linezolid therapy was continued. Subsequently, both the patients developed serotonin syndrome along with persistent peripheral neuropathy. One of the two patients had received psychotropic treatment with loxapine, amitriptyline and clonazepam, which resulted in the development of serotonin syndrome because of drug-drug interaction between linezolid and the psychotropic treatment. Hence, linezolid was stopped for both the patients. Later, both the patients died due to unknown cause. Jaspard M, et al. Linezolid-associated neurologic adverse events in patients with multidrug-resistant tuberculosis, France. Emerging Infectious Diseases 26: 1792-1800, No. 8, 803502335 Aug 2020. Available from: URL: http://doi.org/10.3201/eid2608.191499

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