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Updated: Aug 8, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antibiotics: neuropsychiatric effects and psychotropic interactions
1Department of Psychiatry, UCLA-Neuropsychiatric Institute, USA.
Harvard Review of Psychiatry
|January 14, 1998
Summary
Antibiotics can cause serious central nervous system side effects, impacting mental health. Understanding these risks and drug interactions is crucial for patient care.
Area of Science:
- Neuropharmacology
- Psychiatry
- Infectious Diseases
Background:
- Antibiotics are widely prescribed, second only to cardiovascular drugs in the US.
- Numerous reports link antibiotic use to psychiatric side effects, from anxiety to psychosis.
- These effects can occur in patients with or without prior psychiatric history.
Purpose of the Study:
- To review the central nervous system (CNS) effects of antibiotics.
- To highlight potential interactions between antibiotics and psychotropic medications.
- To increase clinician awareness of antibiotic-induced neuropsychiatric symptoms.
Main Methods:
- Literature review of anecdotal reports and case studies.
- Analysis of proposed mechanisms of antibiotic neurotoxicity.
- Examination of pharmacokinetic and pharmacodynamic interactions.
Main Results:
- Reported psychiatric side effects include anxiety, depression, psychosis, and delirium.
- Risk factors include pre-existing psychopathology, age, and administration route.
- Mechanisms involve GABA antagonism, pyridoxine deficiency, and protein synthesis inhibition.
- Adverse interactions with psychotropic drugs like lithium and benzodiazepines are documented.
Conclusions:
- Antibiotic-induced neuropsychiatric toxicity is a recognized but often underdiagnosed phenomenon.
- Clinicians must consider antibiotic effects when evaluating neuropsychiatric symptoms.
- Further research is needed to establish accurate incidence data.
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