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Ciprofloxacin-induced psychosis.

¹Department of Psychiatry and Behavioral Sciences, University of Oklahoma College of Medicine-Tulsa 74129.

The Annals of Pharmacotherapy

|July 1, 1992

Summary

Ciprofloxacin can cause severe psychosis, a rare but serious central nervous system adverse effect. Healthcare providers should exercise caution when prescribing this antibiotic to patients with a history of psychosis.

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Area of Science:

Pharmacology
Neuroscience
Psychiatry

Background:

Ciprofloxacin, a fluoroquinolone antibiotic, is widely prescribed.
Central nervous system (CNS) adverse effects are uncommon but can occur.
Psychiatric adverse events, including psychosis, are rare but documented.

Observation:

A 49-year-old male developed severe psychosis during ciprofloxacin treatment (250 mg twice daily).
This case highlights a rare but significant CNS adverse reaction to ciprofloxacin.
Reported CNS effects typically include dizziness or headache, with seizures and hallucinations being infrequent.

Findings:

The exact mechanism of ciprofloxacin-induced psychosis remains unclear.
Quinolones may exert an epileptogenic effect by interfering with GABA receptor binding.
Further research is needed to elucidate the pathways leading to hallucinations and psychosis.

Implications:

Clinicians should exercise caution when prescribing ciprofloxacin to patients with pre-existing psychiatric conditions or personality abnormalities.
Awareness of this potential adverse effect is crucial for early detection and management.
This case underscores the importance of monitoring for neuropsychiatric symptoms during fluoroquinolone therapy.

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