Antibiotics: Neuropsychiatric Effects and Psychotropic Interactions

摘要: Antibiotics are the second most commonly prescribed class of medication in United States. An awareness and understanding their potential effects on central nervous system interactions with psychotropic agents is important evaluation neuropsychiatric signs symptoms patients. Since introduction antibiotic 1930s, numerous (primarily anecdotal) reports have appeared describing psychiatric side ranging from anxiety panic to major depression, psychosis, delirium patients without a premorbid history. Risk factors included prior psychopathology, coexisting medical conditions, slow acetylator status, advanced age, concomitant medications, increased permeability blood-brain barrier, as well high dosage intrathecal or intravenous administration. Psychiatric toxicity may result various mechanisms action, including antagonism gamma-aminobutyric acid pyridoxine, adverse alcohol, inhibition protein synthesis. Adverse pharmacokinetic pharmacodynamic between antibiotics medications lithium, benzodiazepines, carbamazepine, valproate, neuroleptics, antidepressants, methadone, disulfiram also been reported. Because such often not recognized by clinicians, accurate epidemiologic data incidence available.