TY - JOUR
T1 - Antibiomania after triple therapy for Helicobacter pylori
T2 - Two case reports and a review of physiopathology
AU - Miñambres, Aitor
AU - Cuevas-Esteban, Jorge
AU - Pardo, Marta
AU - Baladón, Luisa
AU - Planella, Marc
PY - 2014/4
Y1 - 2014/4
N2 - Background and Objectives: The onset of manic symptoms in middle age requires clinicians to consider possible reversible causes, especially in patients with no previous psychiatric history. A number of drugs have been implicated as being among possible causes. The term antibiomania appeared to define cases of antibiotic-induced manic symptoms. This is a serious, but rare, adverse event. Several studies have described antimicrobial agents as being responsible for antibiomania. Our objective is to investigate the possible induction of manic symptoms by clarithromycin through two case reports and a review of the literature. Methods: We report two cases of clinical manic psychotic symptoms arising in the context of treatment with triple therapy for Helicobacter pylori eradication. In addition, we summarize, in an unsystematic way, previously published evidence and pathophysiological mechanisms proposed. Conclusions: These and other previously published cases suggest that the use of triple therapy, and especially of clarithromycin, should always be considered as a possible cause of acute manic or psychotic episode. Published evidence on the pathophysiological mechanisms is speculative so the identification and dissemination of a larger number of antibiomania cases and systematic study of them may help us to understand the underlying pathophysiological mechanisms and improve our diagnostic skills.
AB - Background and Objectives: The onset of manic symptoms in middle age requires clinicians to consider possible reversible causes, especially in patients with no previous psychiatric history. A number of drugs have been implicated as being among possible causes. The term antibiomania appeared to define cases of antibiotic-induced manic symptoms. This is a serious, but rare, adverse event. Several studies have described antimicrobial agents as being responsible for antibiomania. Our objective is to investigate the possible induction of manic symptoms by clarithromycin through two case reports and a review of the literature. Methods: We report two cases of clinical manic psychotic symptoms arising in the context of treatment with triple therapy for Helicobacter pylori eradication. In addition, we summarize, in an unsystematic way, previously published evidence and pathophysiological mechanisms proposed. Conclusions: These and other previously published cases suggest that the use of triple therapy, and especially of clarithromycin, should always be considered as a possible cause of acute manic or psychotic episode. Published evidence on the pathophysiological mechanisms is speculative so the identification and dissemination of a larger number of antibiomania cases and systematic study of them may help us to understand the underlying pathophysiological mechanisms and improve our diagnostic skills.
KW - Antibiomania
KW - Antibiotic
KW - Bipolar disorder
KW - Clarithromycin
KW - Manic episode
KW - Psychosis
UR - http://www.scopus.com/inward/record.url?scp=84904498009&partnerID=8YFLogxK
U2 - 10.4321/S0213-61632014000200003
DO - 10.4321/S0213-61632014000200003
M3 - Article
AN - SCOPUS:84904498009
SN - 0213-6163
VL - 28
SP - 96
EP - 103
JO - European Journal of Psychiatry
JF - European Journal of Psychiatry
IS - 2
ER -