Because of γ-Aminobutyric Acid-Glutamate Imbalance, Gut Microbiota, or Both? Delirious Mania Induced by Ciprofloxacin Use: A Case Report and Review of the Literature

SAKALLI KANİ A., SÜLEYMAN A.

Journal of Psychiatric Practice, vol.31, no.1, pp.46-48, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1097/pra.0000000000000836
  • Journal Name: Journal of Psychiatric Practice
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE, Psycinfo
  • Page Numbers: pp.46-48
  • Keywords: adverse event, ciprofloxacin, delirious mania, mania, neuropsychiatric
  • Marmara University Affiliated: Yes

Abstract

Ciprofloxacin is an antibiotic from the fluoroquinolone group that is frequently used in many clinical practices. In addition to its peripheral neuropathic side effects, it is an antibiotic that can pass through the blood-brain barrier due to its lipophilic features and cause rare central nervous system symptoms. Although cases of neuropsychiatric symptoms developing after treatment with ciprofloxacin have been reported in the literature, the number of reports of manic episodes after ciprofloxacin use is limited, and there have been no reports of delirious mania developing after ciprofloxacin use until the case presented in this report. Here we report the case of a 52-year-old woman who developed manic symptoms after receiving ciprofloxacin, which evolved into delirious mania. Clinical factors that may predispose to neurotoxicity are discussed and compared with features of the mania cases in the literature. The underlying neurobiological mechanisms are also reviewed.