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Area of Science:

  • Pharmacology
  • Psychiatry
  • Infectious Diseases

Background:

  • Quinolones are widely prescribed antibiotics with a generally favorable safety profile.
  • Neuropsychiatric adverse effects, including induced-psychotic episodes, are known but understudied complications.
  • Induced-psychotic episodes are a significant clinical concern due to the high prevalence of quinolone use.

Purpose of the Study:

  • To investigate the phenomenon of quinolone-induced psychosis.
  • To summarize existing literature on substance-induced psychotic disorder linked to quinolone antibiotics.

Main Methods:

  • A comprehensive literature search was conducted on PubMed and ScienceDirect.
  • PRISMA guidelines were followed for the period of 1962 to 2019.
  • Included studies described DSM-5 substance-induced psychotic disorder not attributed to delirium or other psychiatric disorders.

Main Results:

  • 27 manuscripts met the inclusion criteria, involving 27 patients.
  • The median age of affected patients was 36.15 years.
  • Ciprofloxacin, levofloxacin, and ofloxacin were the most frequently implicated antibiotics.

Conclusions:

  • Quinolone-induced psychosis is a clinically relevant issue due to widespread antibiotic use and syndrome severity.
  • The syndrome typically remits within days upon quinolone discontinuation and symptomatic support.
  • Further research is warranted to better understand and manage this adverse effect.