Warning over disturbing ‘antibiomania’ as man plunges into deep psychosis after taking common drug
A MAN was plunged into a psychotic episode after antibiotics for a common infection triggered terrifying ‘antibiomania’.
The 66-year-old began talking incoherently, raving and thinking he was all-powerful, just a day into taking the drugs.
Antibiomania is a very rare side effect of treatment with antibiotics.
It describes the onset of manic symptoms – over active and high energy behaviour – after taking the pills.
According to medics writing in Journal of Medical Case Reports, mania is characterised by “an abnormal and persistent elevation in mood, energy, or activity, all constituting a break with the usual and previous psychological state”.
“We frequently find a reduction in the need for sleep, a significant flow of speech, acceleration of thought with flight of ideas, an increase in self-esteem, and risky behaviours,” they said.
The 66-year-old’s terrifying plunge into mania started when he was diagnosed with a urinary tract infection (UTI) after experiencing a burning sensation while peeing.
Urine samples taken by his GP identified Klebsiella pneumoniae and then man, from France, was given a five day course of the antibiotic levofloxacin.
After five days, the patients was switched to a different drug – cotrimoxazole – to be taken morning and evening, so that he didn’t develop a resistance to the original medication.
After taking his two prescribed doses of the medication on the first day, the man started displaying peculiar symptoms.
He began babbling uncontrollably and incoherently, with his “significant flow of speech” becoming more forceful as the days went on.
He became extremely talkative and euphoric, jumping from topic, seamed to think he was all-powerful and had trouble sleeping.
“Given the worsening of the clinical picture”, doctors decided to switch the patient back to levofloxacin – but this did little to improve his symptoms.
Continuing to rave and ramble, the man was taken to the emergency department of the University Hospital Center of Reims two days later.
Medics carried out a battery of blood tests, urine tests and brain scans, detecting that he was suffering from acute renal failure but finding little explanation for his psychological symptoms.
Thinking he might have been struck by a sudden bout of confusion, the patient was transferred the next day to the hospital’s medical department so that his kidney function could be monitored and he could continue antibiotic treatment for his UTI.
As his UTI symptoms improved, he continued to be assessed for conditions like Alzheimer’s disease, with medics eventually requesting a psychiatric opinion.
It was found that the 66-year-old had previously been hospitalised for psychiatric episodes three times over a six month period, 16 years prior.
During those episodes – which had been triggered by family and work stress – he’d been extremely talkative, made incoherent remarks and had hallucinations, which were all resolved with treatment.
As for the more recent outburst , it was determined that the man was suffering from a manic episode triggered by the antibiotics.
Everything you need to know about antibiotics
ANTIBIOTICS are usually something you'll come across if you suffer a nasty bug.
The life-saving pills are used by millions every year, for a whole host of issues.
They are specifically used to help our bodies fight off bacterial infections.
And once upon a time, they were handed out relatively freely.
But many countries have joined the fight to prevent antibiotic resistance, the drugs are no longer routinely used to treat all infections.
Antibiotics don’t work for everything and here we take a look at how long it takes them to work and whether or not you need to take the full course.
How long does it take for antibiotics to start working?
Antibiotics start to work straight away — but you might not get them until you’ve felt unwell for a while.
They work by or preventing bacteria from spreading or killing them, the NHS states.
However, they don’t work for viral infections.
This includes colds and flu, Covid, chest infections, ear infections in children, and most coughs and sore throats.
In most cases they will be prescribed to you if the bacterial infection won’t clear up without them or if you could infect others.
Medication could also be given if the infection would take too long to clear on its own or if it carries the risk of more serious complications.
When will I feel better?
Everyone is different – as is their response to antibiotics.
Most people will feel better towards the end of the course, but this varies, and will depend on the drug being taken.
Most antibiotics should be taken for one to two weeks but shorter treatments work just as well in some cases.
Your doctor will decide the best length of treatment and correct antibiotic type for you.
If you have completed the course and don’t see any signs of improvement, talk to your doctor or pharmacist.
Do I need to take my full course of antibiotics?
It can be tempting to stop taking antibiotics as soon as you’re starting to feel better – but doctors say you shouldn’t as it can result in the infection returning.
Doing so also contributes to the growing issue of antibiotic resistance.
If you forget to take an antibiotic, it’s not the end of the world, but take that dose as soon as you remember and carry on with the course of antibiotics as normal.
But if it’s almost time for the next dose, skip the missed one and continue your regular dosing schedule.
Do not take a double dose to make up for a missed one as this can increase the risk of side effects.
What are the side effects?
The NHS states that most commonly, people will feel sick, be sick, have bloating and indigestion, while others also have diarrhoea.
Guidance states that some people might also have an allergic reaction to the medication – especially penicillin and another type of antibiotic called cephalosporins
“We hypothesised [it was] mainly linked to cotrimoxazole, owing to the delay in the appearance of symptoms after the introduction of this treatment,” doctors handling his care wrote.
“Given the patient’s psychiatric history of brief psychotic episodes with mood elements, there seemed to be a certain vulnerability, raising questions about the presence of a bipolar disorder,” they added.
The man was given anti-psychotic medication in addition to drugs commonly used to treat schizophrenia.
“A gradual improvement in the various symptoms was noted within a week, which allowed the patient to leave the hospital,” doctors said.
“The patient benefited from psychiatric follow-up for several months, during which haloperidol [the antipsychotic drug] was gradually stopped without resurgence of psychiatric symptoms.”
They concluded: “This case report also illustrates the importance of being aware of the phenomenon of antibiomania, especially in bipolar patients taking antibiotics, to initiate appropriate care as early as possible.”