Psychosis as an adverse effect of antibiotics - ScienceDirect
As shown in Table 1, compared to minocycline, 15 of the 23 antibiotics were associated with a significantly increased odds of psychosis (OR = 1.67–9.48), including amoxicillin/clavulanate, ceftriaxone, SMX/TMP, cephalexin, azithromycin, doxycycline, nitrofurantoin, erythromycin, cefuroxime, amoxicillin, cefepime, levofloxacin, metronidazole, ciprofloxacin, and clarithromycin. 6 of the 23 antibiotics showed non-significant increased odds of increased psychosis, including tetracycline, clindamycin, amikacin, piperacillin, penicillin, and meropenem. By contrast, 2 of the 23 antibiotics were associated with a non-significantly decreased odds of psychosis compared to minocycline; vancomycin (OR = 0.80, 95% CI 0.46–1.39) and gentamicin (OR = 0.81, 95% CI 0.36–1.82). In a post-hoc analysis, we calculated ORs only for hallucinations (in any sensory modality) as this was the most reported psychotic ADR, which did not change the pattern of findings. As a class, compared to minocycline, there was a significant increased odds of psychosis for other tetracyclines (OR = 2.23), penicillins (OR = 2.15), fluoroquinolones (OR = 6.11), macrolides (OR = 7.04), and cephalosporins (OR = 2.25), but not aminoglycosides.