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Antibiotics and mania: A systematic review.
Simon Lambrichts1, Lukas Van Oudenhove2, Pascal Sienaert3
1KU Leuven, University Psychiatric Center KU Leuven, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium.
Journal of Affective Disorders
|May 28, 2017
Summary
Antibiotic-induced mania, or antibiomania, is a rare phenomenon. While 47 cases are reported, the exact mechanism remains unknown, necessitating drug discontinuation if suspected.
Area of Science:
- Psychiatry
- Pharmacology
- Neurology
Background:
- Mania can manifest secondary to medical conditions or pharmacological treatments.
- Antibiotic-induced mania (antibiomania) is considered a rare adverse effect.
- This phenomenon can occur in individuals with or without a prior history of affective disorders.
Purpose of the Study:
- To review and compile published reports of antibiomania.
- To explore potential mechanisms underlying antibiotic-induced mania.
- To provide insights into the management of this condition.
Main Methods:
- A comprehensive MEDLINE search was conducted.
- Manual cross-referencing was employed to identify relevant literature.
- Cases were included if a (hypo)manic episode occurred in close temporal proximity to antibiotic prescription.
Main Results:
- A total of 47 cases of antibiomania were identified in the literature.
- Patient ages ranged from 3 to 77 years, with a mean age of 40.
- Antitubercular agents, macrolides, and quinolones were the most frequently implicated antibiotic classes.
Conclusions:
- Antibiotic use can be associated with the development of (hypo)manic episodes.
- The low number of reported cases limits the ability to determine incidence or issue specific warnings.
- Discontinuation of the suspected antibiotic and standard treatment for manic symptoms are recommended; the underlying mechanism is still unclear.
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