Moxifloxacin-induced acute psychosis: A case report with literature review

Mazhar, Faizan; Akram, Shahzad; Haider, Nafis

doi:10.4103/2279-042x.192457

Cited by 14 publications

(12 citation statements)

References 13 publications

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“…In our study, both of the patients developed psychotic symptoms at the 500-mg/day dosage, and the peak serum concentration in one patient was only 12.12 g/ml. However, both patients were administered fluoroquinolone simultaneously, and psychotic symptoms are one of its possible side effects as well (16,17). Although a peak serum concentration lower than 20 g/ml was a risk factor for unfavorable treatment outcome (odds ratio [OR] ϭ 0.429), our assay did not show a statistically significant difference between groups with Cs concentrations lower than or within the recommend concentrations considering the therapy outcomes (P ϭ 0.428).…”

Section: Discussionmentioning

confidence: 62%

Validation of Cycloserine Efficacy in Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Beijing, China

Zeng

Shi

et al. 2018

Antimicrob Agents Chemother

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Cycloserine (Cs) is recommended by the World Health Organization as a second-line drug to treat multidrug-resistant tuberculosis (MDR-TB); however, its efficacy has never been sufficiently evaluated. To gain some insights into the value of cycloserine for MDR-TB treatment, bacteriostatic effect was determined and patient validations were performed prospectively. The activity of Cs against 104 wild-type strains was determined, and serum Cs concentrations were measured for 73 MDR TB patients 2 h after administration. The treatment outcomes for 27 MDR-TB patients who had baseline isolates and were treated with Cs-containing regimens were followed up. The MICs for 90% of the recruited 104 wild-type strains were below 32 μg/ml. Eighteen out of 52 patients had peak serum concentrations () below 20 μg/ml at the dosage of 500 mg daily, while 13 out of 21 patients had peak serum concentrations higher than 35 μg/ml at the dosage of 750 mg daily. The percentage of favorable treatment outcomes among patients with a /MIC ratio of ≥1 was statistically significantly higher than that among the group with a/MIC ratio of <1 ( = 0.022). The epidemiological cutoff value for Cs susceptibility testing was 32 μg/ml. A high percentage of patients receiving the recommended dosage of 10 mg/kg for Cs administration could not acquire desirable blood concentrations; therefore, adjusting the dosage according to drug concentration monitoring is necessary. The /MIC ratio might be a good indicator for predicting the treatment outcome for patients with MDR-TB or extensively drug-resistant TB (XDR-TB) who are being administered Cs-containing regimens.

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Section: Discussionmentioning

confidence: 62%

Validation of Cycloserine Efficacy in Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Beijing, China

Zeng

Shi

et al. 2018

Antimicrob Agents Chemother

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“…Moxifloxacin reported to induce psychosis and hallucinations[9] of our patient did not resolve spontaneously with discontinuation of it. Even if more than 1-month period had been passed without moxifloxacin, hypomanic symptoms continued.…”

Section: Discussionmentioning

confidence: 63%

Haloperidol-related neutropenia

Şahan

2019

Indian J Psychiatry

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Phenothiazines like antipsychotics have been known to cause neutropenia, but this has been reported very rarely with haloperidol. A 20-year-old male patient admitted to emergency service (emergency room) with shortness of breath, chest pain, and anger. He was diagnosed with pneumonia and prescribed moxifloxacin. After 2 days with antibiotic, he readmitted. Left lung pneumothorax was detected, and thorax computerized tomography was requested. However, he opposed and beated one of the hospital officials. The diagnosis of manic episode due to antibiotic moxifloxacin was considered. The tube thoracostomy had to be done, and antibiotic therapy was stopped. Haloperidol 10 mg/day and biperiden 4 mg/day injections were administered because he continued to resist medical interventions. After haloperidol, his leukocyte count decreased. He responded well to filgrastim (Neupogen) and blood transfusions, so a drug-related cause of neutropenia has been suspected. He was switched from haloperidol to quetiapine 300 mg twice a day. His white blood cell count returned to normal levels.

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“…A systematic search for CNS related complication was conducted by Tandan et al who showed that the risk of developing CNS related complications with fluoroquinolones are ~ 3 times higher than with any other antimicrobial agent 74 . Furthermore, recent case studies regarding another fluoroquinolone, Moxifloxacin, showed that the drug is closely associated with the development of visual hallucinations, alterations in mood and behavior, and some severe forms of acute psychosis 75 , 76 . It is obvious that many of these CNS complications overlap with the physiological roles of the 5HT receptors.…”

Section: Resultsmentioning

confidence: 99%

GPCR_LigandClassify.py; a rigorous machine learning classifier for GPCR targeting compounds

Ahmed

Hasani

Kalyaanamoorthy

et al. 2021

Sci Rep

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The current study describes the construction of various ligand-based machine learning models to be used for drug-repurposing against the family of G-Protein Coupled Receptors (GPCRs). In building these models, we collected > 500,000 data points, encompassing experimentally measured molecular association data of > 160,000 unique ligands against > 250 GPCRs. These data points were retrieved from the GPCR-Ligand Association (GLASS) database. We have used diverse molecular featurization methods to describe the input molecules. Multiple supervised ML algorithms were developed, tested and compared for their accuracy, F scores, as well as for their Matthews’ correlation coefficient scores (MCC). Our data suggest that combined with molecular fingerprinting, ensemble decision trees and gradient boosted trees ML algorithms are on the accuracy border of the rather sophisticated deep neural nets (DNNs)-based algorithms. On a test dataset, these models displayed an excellent performance, reaching a ~ 90% classification accuracy. Additionally, we showcase a few examples where our models were able to identify interesting connections between known drugs from the Drug-Bank database and members of the GPCR family of receptors. Our findings are in excellent agreement with previously reported experimental observations in the literature. We hope the models presented in this paper synergize with the currently ongoing interest of applying machine learning modeling in the field of drug repurposing and computational drug discovery in general.

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Moxifloxacin-induced acute psychosis: A case report with literature review

Cited by 14 publications

References 13 publications

Validation of Cycloserine Efficacy in Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Beijing, China

Validation of Cycloserine Efficacy in Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Beijing, China

Haloperidol-related neutropenia

GPCR_LigandClassify.py; a rigorous machine learning classifier for GPCR targeting compounds

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