Antibiomania: An update

Area of Science:

• Neuropsychiatry
• Microbiome Research
• Pharmacology

Background:

• Antibiomania is a poorly understood phenomenon where antibiotic use can precipitate manic or hypomanic episodes.
• This condition can affect individuals with or without a prior bipolar disorder diagnosis.
• Its diagnostic elusiveness may lead to underrecognition and underreporting.

Purpose of the Study:

• To provide an overview of antibiomania.
• To explore potential mechanisms linking antibiotic use to manic episodes.
• To highlight the need for further investigation and clinical awareness.

Main Methods:

• Review of representative studies.
• Analysis of clinical observations and case reports.
• Consideration of mechanistic pathways.

Main Results:

• Antibiotic-induced gut dysbiosis is a primary suspected mechanism.
• Activation of gut-brain axis pathways may mediate the manic/hypomanic episodes.
• Several mechanistic factors are discussed, with a focus on the gut microbiome.

Conclusions:

• Further research is needed to establish the prevalence of antibiomania.
• Investigating differential risks associated with various antibiotics is crucial.
• Clinicians should consider antibiomania in patients presenting with new or recurrent manic/hypomanic episodes, exploring tailored management strategies.