Simon Lambrichts1, Lukas Van Oudenhove2, Pascal Sienaert3. 1. KU Leuven, University Psychiatric Center KU Leuven, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium. 2. Laboratory for Brain-Gut Axis Studies (LABGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium; Consultation-Liaison Psychiatry, University Psychiatric Center KU Leuven, Campus Gasthuisberg, University of Leuven, Leuven, Belgium. 3. KU Leuven, University Psychiatric Center KU Leuven, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium; Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. Electronic address: pascal.sienaert@upckuleuven.be.
Abstract
OBJECTIVES: Mania can occur secondary to a medical condition and can be elicited by various pharmacological treatments, both in patients with or without a history of affective disorder. Antibiotic-induced mania or antibiomania is suggested to be a rare phenomenon. We reviewed the literature in order to collect published reports of antibiomania and to summarize new insights about its mechanism and management. METHODS: We performed a MEDLINE-search and used manual cross-referencing for reports of antibiotic-induced mania and included cases in which a (hypo)manic episode was diagnosed in close temporal relationship with the prescription of an antibiotic. RESULTS: 47 cases were published. Patients' ages ranged from 3 to 77 years (mean 40). Two-thirds of the cases were male. Twelve different anti-bacterial agents were implicated, with antitubercular agents, macrolides and quinolones being the most common causative groups. CONCLUSIONS: Antibiotic treatment can be associated with (hypo)mania. The paucity of reported cases precludes statements regarding incidence or antibiotic-specific warnings. In the event of an antibiotic-induced mania, the suspicious drug should be discontinued and manic symptoms can be treated lege artis. The pathophysiological mechanism of antibiomania remains elusive.
OBJECTIVES:Mania can occur secondary to a medical condition and can be elicited by various pharmacological treatments, both in patients with or without a history of affective disorder. Antibiotic-induced mania or antibiomania is suggested to be a rare phenomenon. We reviewed the literature in order to collect published reports of antibiomania and to summarize new insights about its mechanism and management. METHODS: We performed a MEDLINE-search and used manual cross-referencing for reports of antibiotic-induced mania and included cases in which a (hypo)manic episode was diagnosed in close temporal relationship with the prescription of an antibiotic. RESULTS: 47 cases were published. Patients' ages ranged from 3 to 77 years (mean 40). Two-thirds of the cases were male. Twelve different anti-bacterial agents were implicated, with antitubercular agents, macrolides and quinolones being the most common causative groups. CONCLUSIONS: Antibiotic treatment can be associated with (hypo)mania. The paucity of reported cases precludes statements regarding incidence or antibiotic-specific warnings. In the event of an antibiotic-induced mania, the suspicious drug should be discontinued and manic symptoms can be treated lege artis. The pathophysiological mechanism of antibiomania remains elusive.
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