Hallucinations with therapeutic doses of clarithromycin

Transient Psychotic Episode Induced byHelicobacter pyloriTriple Therapy Treatment

“…She returned to baseline 3 days after terminating treatment [24]. There are several other reports in the literature describing mania after starting clarithromycin monotherapy with extinction of symptoms within several days (average 3–5 days) of discontinuing this drug [25, 26, 27, 28, 29]. …”

Visual Hallucinations Possibly Associated with Clarithromycin Administration at Therapeutic Dosage in Two Children

“…Lightheadedness, dizziness, confusion, insomnia and tinnitus have been reported in elderly patients treated with high-dose clarithromycin (1 g twice daily) [6] . Clarithromycin-associated hallucinations or psychotic behavior were attributed to drug interactions involving the capacity of macrolides to inhibit cytochrome p 450, thereby increasing the plasma concentration of drugs given in combination [1,[7][8][9] . Probable clarithromycin-associated hallucination had also been reported in a 56-year-old man with chronic renal failure.…”

“…In this case, poor renal function could possibly have facilitated the occurrence of this adverse reaction by altering the blood brain barrier, which could have increased the central nervous system concentrations of clarithromycin [2] . In 2002, Jiménez-Pulido et al [1] reported that an adverse reaction to clarithromycin was the probable cause of the visual hallucinations according to the Naranjo algorithm [10] in a 32-year-old woman receiving therapeutic doses of clarithromycin for upper respiratory tract infection. She had no medication other than clarithromycin or any systemic disorders as our patients, but unlike in this report our patients were not adults.…”

“…Several adverse reactions have been associated with the ingestion of clarithromycin, and the most frequently reported ones are gastrointestinal in nature [1,2] . We describe acute transient visual hallucinations associated with clarithromycin ingestion in 2 children.…”

Study of CNS Effects of Macrolide Antibiotics: An Experimental Study

“…However some of the CNS related adverse effects are also reported possible due to use of large dose for long period of time and as a drug interaction. 2 Some sporadic cases of CNS effects like dizziness, transient deafness, delirium, apparent fatigue, disorientation, have been reported during monotherapy. 3 Very few studies have been done to study the CNS related effects of macrolides antibiotics.…”