PSYCHIATRIC SIDE-EFFECTS OF SYSTEMIC QUINOLONES

Neurologic side-effects of quinolones have been described previously. Still, psychiatric side-effects of those are less described. We conducted a prospective, exhaustive notification of psychiatric side-effects due to quinolones between December 1991 and June 1993. We report 10 cases : hallucinations = 6; nightmares = 3; suicide = 1.239 patients received quinolones (Pefloxacin = 67, Ofloxacin = 91, Norfloxacin = 48, Ciprofloxacin = 33) during the study period. Mean age was 58 years, all were women. 9 out of 10 took Pefloxacin, the last had Norfloxacin. Indications were : urinary tract infection with septicemia = 4; acute feverish diarrhea = 3; S. aureus septicemia = 2; arthritis = 1. 8 cases occured less than 3 days after treatment onset. Imputability was found to be : very probable = 3; probable = 4; plausible = 3. All patients but one improved after treatment withdrawal. Inhibition of gamma-aminobutyric acid (GABA) binding to the GABA receptor may be the underlying mechanism. We must pay attention for - associations with NSAID - hepatic dysfunction - and elderly patients when using quinolones.