An acute psychotic disorder caused by pefloxacin: a case report

The First Case of Ceftazidime-Induced Antibiomania: A Case Report and Literature Review

Antibiomania is a rare type of secondary mania caused by antibiotics. Here, we describe the first case report of antibiomania in a peritoneal dialysis patient caused by ceftazidime, a cephalosporin antibiotic. Manic symptoms were noted in the patient described here a few days after starting the antibiotic and worsened over the course of a few weeks of antibiotic treatment. There is a close temporal relationship between the start of antibiotics and the onset of manic symptoms in this case. Antibiotics from various groups have been implicated as the causative agents in a few case reports of antibiomania. Several hypotheses have been postulated regarding the underlying mechanism of antibiomania. The authors of this article highlight the importance of recognizing the psychiatric side effects of antibiotics early and formulating effective management options to prevent detrimental effects on a patient's clinical condition.

Antibiotics and mania: A systematic review

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.