An acute psychotic disorder caused by pefloxacin: a case report

1. The patient, a 59 year old woman, developed a state of acute excitation several hours after the administration of 400 mg of the fluorquinolone pefloxacin in combination with 1000 mg paracetamol. Nine days later, after a total dosage of pefloxacin of 800 mg, she was admitted to our hospital with a psychotic disorder. 2. There was a full remission of symptoms after treatment with perazine up to a dosage of 500 mg/day. 3. Three years ago, the patient had developed a manic state under a medication with corticosteroids. 4. So far, the mechanism of--in this case--long-lasting central nervous side effects of fluorquinolones is not known. In patients with increased vulnerability of the CNS or in advanced age the application of fluorquinolones should be considered critically, in particular in combination with non-steroidal anti-inflammatory drugs.