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Neurological and Psychiatric Adverse Effects of Antimicrobials

Madison K Bangert1, Rodrigo Hasbun2

  • 1Section of Infectious Diseases, Department of Medicine, UT Health McGovern Medical School, 6431 Fannin St. MSB 2.112, Houston, TX, 77030, USA.

CNS Drugs
|July 20, 2019
PubMed

Insights

Antimicrobials can cause neurological and psychiatric side effects, impacting cognition. Recognizing these neurotoxic effects is crucial for timely diagnosis and treatment, as symptoms often reverse upon drug withdrawal.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Infectious Diseases

Background:

  • Antimicrobials are essential for treating infections but can cause neurological and psychiatric adverse effects.
  • The incidence of antimicrobial-induced neurotoxicity is estimated to be less than 1%.

Purpose of the Study:

  • To review the neurotoxic effects of various antimicrobials.
  • To discuss potential mechanisms of neurotoxicity and provide management strategies.
  • To briefly examine the impact of antibiotics on the gut microbiome and cognition.

Main Methods:

  • Literature review of antimicrobial-induced neurotoxicity.
  • Analysis of reported neurological and psychiatric side effects.
  • Discussion of proposed pathophysiological mechanisms.
  • Examination of the relationship between gut microbiome and neurotoxicity.

Main Results:

  • Neurotoxicity is observed across all antimicrobial classes (antibiotics, antifungals, antivirals, etc.).
  • Reported side effects range from headaches and anxiety to psychosis and seizures.
  • Reversibility of symptoms is common following antimicrobial withdrawal.

Conclusions:

  • Antimicrobial neurotoxicity is a recognized but infrequent adverse effect with a broad spectrum of presentations.
  • Awareness and prompt recognition are vital to prevent misdiagnosis and ensure appropriate patient management.
  • Further research into mechanisms, including gut microbiome interactions, may elucidate preventative and therapeutic strategies.

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