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Doxycycline, an antibiotic, was linked to suicidal ideation and suicide in three young patients with no prior mental health issues. Discontinuation of the drug resolved symptoms in all cases, suggesting a potential adverse effect.

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Area of Science:

  • Pharmacovigilance
  • Neuropsychiatry
  • Genetics

Background:

  • Doxycycline is a widely prescribed antibiotic for various infections.
  • Mental health adverse effects of antibiotics are increasingly recognized.
  • Genetic factors may influence drug metabolism and toxicity.

Observation:

  • Three young patients without prior mental health diagnoses developed suicidal ideation while on doxycycline for skin conditions.
  • Two cases resulted in suicide, while the third experienced mood difficulties that resolved upon doxycycline discontinuation.
  • One patient with suicidal ideation had a CYP2C19*2 heterozygote genotype, potentially affecting drug metabolism.

Findings:

  • A potential association between doxycycline use and the development of suicidal ideation and severe mood changes was observed.
  • Genetic variations, such as CYP2C19*2, might predispose individuals to adverse neuropsychiatric events from doxycycline.
  • Symptom resolution after doxycycline cessation suggests a causal link.

Implications:

  • Healthcare providers should be vigilant for neuropsychiatric side effects of doxycycline, especially in young patients.
  • Further research into the pharmacogenetics of doxycycline is warranted to identify at-risk populations.
  • Consideration of alternative treatments may be necessary for patients with a history of mood disturbances or genetic predispositions.