Acceso usuarios
Aitor Miñambres, Jorge Cuevas Esteban, Marta Pardo, Luisa Baladón, Marc Planella
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
