Psychopathologische Syndrome unter Behandlung mit Gyrasehemmern

Abstract

Psychopathological and neurological adverse drug reactions (ADR) have been repeatedly reported during treatment with gyrase inhibitors (fluorquinolones). Results of earlier studies indicated a high risk for ADR especially in the elderly with high dosage medication, psychiatric history and renal dysfunction. The pathophysiological mechanisms involved in the development of adverse CNS effects are not completely understood. GABA-ergic and monoaminergic mechanisms might play a major part. In a retrospective study conducted by the authors 4189 reports of consultant psychiatric examinations were analyzed. In 29 patients the suspicion of psychopathological ADR during treatment with ofloxacin or ciprofloxacin was documented. Psychopathological findings included delirious states, paranoid, depressive and manic syndromes, agitation, sleep disturbances, sopor and stupor. In elderly patients delirious and paranoid syndromes were predominant, whereas affective disturbances occurred more often in younger patients. In most cases multiple morbidity, liver or kidney diseases, simultaneous treatment with other antibiotics and immunosuppressants, former psychiatric disorders or psychosocial stress factors were present. The results of the study, methodological problems, aspects of risk analysis and implications for medical treatment are discussed.

Acute Delusional Parasitosis under Treatment with Ciprofloxacin

“…Among antimicrobial agents, clarithromycin, ciprofloxacin and ofloxacin are those associated most frequently with psychiatric side effects [1,2]. Hallucinations and delusions have been described under treatment with ciprofloxacin [4] as well as the induction of mania [1]. This is the first case reported with delusional parasitosis.…”

“…Gyrase-inhibitors have been reported to cause psychotic symptoms in 20 out of 1.5 million treatment episodes [4,5]. Ciprofloxacin-induced psychoses have been described in some case reports [6 ± 8], occurring sometimes in multi-morbid or personality disordered patients, but also in healthy subjects, even with topical application [11].…”

Multifaktorielle Genese einer verworrenen manischen Episode – potentieller Einfluss des Macrolid Azithromycin und des NASR Diclofenac

“…B. Ciprofloxacin wird eine inihibitorische Interaktion der Chinolonderivate mit GABA-ergen Rezeptoren diskutiert (Hollweg et al 1997;Reeves 1992;Rietbrock & Staib 1987). In Anlehnung an die Beobachtung neurotoxischer Effekte unter Gyrasehemmern wie z.…”

Temperature- and solvent-induced reversible single-crystal-to-single-crystal transformations of TbIII-based MOFs with excellent stabilities and fluorescence sensing properties toward drug molecules

“…[27][28][29][30] In addition, ofloxacin (OFX) and fleroxacin (FO) in fluoroquinolone drugs can affect the stomach, skin and central nervous system of the human body. [31][32][33] The traditional detection methods (high performance liquid chromatography-mass spectrometry and spectrophotometry) are complicated and of high cost. 22,34,35 Therefore, there is an urgent need for simple, rapid and efficient detection of the drugs.…”