Antibiomania after triple therapy for Helicobacter Pylori: Two case reports and a review of physiopathology

• Autores: Aitor Miñambres, Jorge Cuevas Esteban, Marta Pardo, Luisa Baladón, Marc Planella
• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 28, Nº 2, 2014, págs. 96-103
• Idioma: inglés
• DOI: 10.4321/s0213-61632014000200003
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• Resumen

  • 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 pos- sible 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 an- timicrobial 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 con- text of treatment with triple therapy for Helicobacter pylori eradication. In addition, we summarize, in an unsystematic way, previously published evidence and pathophysiologi- cal 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 mech- anisms is speculative so the identification and dissemination of a larger number of an- tibiomania cases and systematic study of them may help us to understand the underlying pathophysiological mechanisms and improve our diagnostic skills