Levofloxacin induced psychosis: a rare case report

Singh, Daljeet; Kapoor, Akhil; Singhal, Mukesh Kumar; Singh, Vikram; Kumar, Harvindra Singh

doi:10.5455/2319-2003.ijbcp20140806

Cited by 5 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Metronidazole (12/30) and vancomycin (7/30) were the most frequent concomitant antibiotics used. Other medications simultaneously administered were paracetamol (6/71) [ 17 , 19 , 27 , 29 , 73 , 75 ] and non-steroidal anti-inflammatory drugs (NSAIDs) (4/71) [ 14 , 40 , 62 , 73 ]. In 11 cases, patients were treated with psychoactive drugs, including opioids [ 20 , 25 , 27 , 51 , 64 , 81 ], antipsychotics [ 31 , 81 ], benzodiazepines [ 25 , 27 , 64 ], 5-hydroxytryptamine antagonists [ 25 , 68 , 69 ], antiepileptic drugs [ 31 , 69 ], dopamine agonists [ 66 ], and antidepressants [ 31 , 72 ].…”

Section: Resultsmentioning

confidence: 99%

Depressive and Other Adverse CNS Effects of Fluoroquinolones

Wierzbiński¹,

Hubska

Henzler

et al. 2023

Pharmaceuticals

View full text Add to dashboard Cite

Fluoroquinolones (FQs) are widely used drugs around the world. This is a result of their broad spectrum of antibacterial activity, high bioavailability, and known efficacy. Since they appeared on the market, their prescribing frequency has gradually increased. In 2011, FQs became the third most prescribed class of antibiotics in the US. Widespread use of these drugs resulted in an increasing number of reported side effects. In 2016, the FDA warned about significant side effects, including mental disorders in the form of anxiety, psychotic symptoms, insomnia, and depression. Psychiatric adverse reactions to FQs occur with a frequency of 1 to 4.4% and the mechanism of their formation is not entirely clear. It is believed that the antagonistic effect of FQs on the GABA receptor or interaction with the main receptor for the glutamatergic system—NMDA—is responsible for this. The paper is a structured review of 68 selected publications and the latest summary of CNS adverse effects that occur during FQ use. Prescribers should be aware of the risk factors for FQ toxicity, including elderly patients with underlying medical conditions or receiving concomitant medication; however, these adverse events may also occur in other groups of patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Depressive and Other Adverse CNS Effects of Fluoroquinolones

Wierzbiński¹,

Hubska

Henzler

et al. 2023

Pharmaceuticals

View full text Add to dashboard Cite

show abstract

“…It shows an antibacterial effect by inhibiting bacterial DNA gyrase and topoisomerase IV enzymes [21] . Like other fluoroquinolones, LVX has serious adverse effects on the central nervous system (CNS), gastrointestinal tract, and bone tissue [22–24] . Side effects of fluoroquinolones in the CNSare caused by their affinity for gamma‐aminobutyric acid (GABA) and N methyl D‐aspartate receptors [25] .…”

Section: Introductionmentioning

confidence: 99%

The Effects of P‐glycoprotein Modulators on the Transition of Levofloxacin to Rat Brain, Testicle, and Plasma: In Vivo and In Silico Studies

2021

View full text Add to dashboard Cite

P‐glycoprotein (P‐gp), a transporter membrane protein, plays an important role in various physiological and physiopathological conditions, drug‐drug and drug‐food interactions, and multi‐drug resistance. Nowadays, P‐gp modulators are used consciously to treat some specific diseases, such as cancer and poisoning. Levofloxacin (LVX), a P‐gp substrate, may cause the stimulation of the central nervous system. The aim of this study was to determine the effects of fexofenadine (FEX) and dexamethasone (DEX) with P‐gp modulators on the distribution of LVX in rat brain, testicle, and plasma. In the in vivo section of the study, LVX concentrations in tissue and plasma samples were detected by high‐performance liquid chromatography. In addition, in silico molecular docking studies were conducted to elucidate interactions between P‐gp and drugs. The administration of DEX at a low dose and minute 30 reduced the LVX passage to the brain, while the administration of DEX at a high dose and hour 2 increased the LVX passage to the brain, testicle tissue, and plasma. MM‐GBSA ΔG values of FEX, DEX, and LVX were calculated to be−80.95,−57.74, and−52.12 kcal/mol, respectively. The results of this study reported that DEX, known as a P‐gp inductor, may show inhibitory activity based on dose, tissue, and time of application.

show abstract

“…There are only very few case reports in the literature associating development of delirium with the use of Levofloxacin. [ 5 6 7 8 9 10 ] Association of occasionally fatal hypersensitivity and/or anaphylactic reactions has also been reported in patients receiving therapy with levofloxacin often following the first dose. [ 11 ] Here we have described a case report of a 17-year-old child who developed anaphylaxis and delirium following intravenous levofloxacin infusion.…”

Section: Introductionmentioning

confidence: 99%

Management of levofloxacin induced anaphylaxis and acute delirium in a palliative care setting

Ghoshal

Damani

Salins

et al. 2015

Indian J Palliat Care

View full text Add to dashboard Cite

Levofloxacin is a commonly prescribed antibiotic for managing chest and urinary tract infections in a palliative care setting. Incidence of Levofloxacin-associated anaphylaxis is rare and delirium secondary to Levofloxacin is a seldom occurrence with only few published case reports. It is an extremely rare occurrence to see this phenomenon in combination. Early identification and prompt intervention reduces both mortality and morbidity. A 17-year-old male with synovial sarcoma of right thigh with chest wall and lung metastasis and with no prior psychiatric morbidity presented to palliative medicine outpatient department with community-acquired pneumonia. He was initiated on intravenous (IV) Ceftriaxone and IV Levofloxacin. Post IV Levofloxacin patient developed anaphylaxis and acute delirium necessitating IV Hydrocortisone, IV Chlorpheneramine, Oxygen and IV Haloperidol. Early detection and prompt intervention helped in complete recovery. Patient was discharged to hospice for respite after 2 days of hospitalization and then discharged home. Acute palliative care approach facilitated management of two life-threatening medical complications in a palliative care setting improving both quality and length of life.

show abstract

Levofloxacin induced psychosis: a rare case report

Cited by 5 publications

References 5 publications

Depressive and Other Adverse CNS Effects of Fluoroquinolones

Depressive and Other Adverse CNS Effects of Fluoroquinolones

The Effects of P‐glycoprotein Modulators on the Transition of Levofloxacin to Rat Brain, Testicle, and Plasma: In Vivo and In Silico Studies

Management of levofloxacin induced anaphylaxis and acute delirium in a palliative care setting

Contact Info

Product

Resources

About