Levofloxacin-Related Delirium: Uncommon Psychiatric Manifestations in Throat Infection Treatment
DOI:
https://doi.org/10.36283/PJMD13-1/021Keywords:
Levofloxacin, Delirium, Psychotic disordersAbstract
We report a case of a 55-year-old man who had a history of ischemic stroke 6 years back and was on follow-up medications. He got a throat infection for which he took levofloxacin 250mg BD as prescribed by the doctor. After taking levofloxacin, the patient developed delirium and symptoms of acute psychosis such as social withdrawal and suspiciousness within 12-24 hours. The symptoms subsided 1 day after the discontinuation of levofloxacin. It can therefore be suspected that Levofloxacin directly contributed to the episode of delirium and acute psychosis witnessed in the patient. This is one of the rare cases of levofloxacin-induced delirium and acute psychosis symptoms seen up till now since the use of levofloxacin by patients. We, therefore, recommend that levofloxacin should be carefully used in patients with underlying psychiatric disorders and patients on levofloxacin should be regularly followed up to notice any such case of levofloxacin-induced delirium and acute psychosis.
References
- Rusu A, Munteanu AC, Arbănași EM, Uivarosi V. Overview of Side-Effects of Antibacterial Fluoroquinolones: New Drugs versus Old Drugs, a Step Forward in the Safety Profile?. Pharmaceutics. 2023;15(3):804. https://doi.org/10.3390/pharmaceutics15030804
- Millanao AR, Mora AY, Villagra NA, Bucarey SA, Hidalgo AA. Biological effects of quinolones: A family of broad-spectrum antimicrobial agents. Molecules. 2021;26(23):7153. https://doi.org/10.3390%2Fmolecules26237153
- Slobodin G, Elias N, Zaygraikin N, Sheikh-Ahmad M, Sabetay S, Weller B, Odeh M. Levofloxacin-induced delirium. Neurological sciences. 2009;30(2):159-161. https://doi.org/10.1007/s10072-009-0027-9
- Moorthy N, Raghavendra N, Venkatarathnamma PN. Levofloxacin-induced acute psychosis. Indian J Psychiatry. 2008;50(1):57-58. https://doi.org/10.4103/0019-5545.39762
- Odeh M, Kogan Y, Paz A, Elias N. Delirium induced by levofloxacin. Journal of Clinical Neuroscience. 2019;66:262-264. https://doi.org/10.1016/j.jocn.2019.05.055
- Kocyigit I, Dortdudak S, Sipahioglu M, Unal A, Yucel HE, Tokgoz B, Eroglu E, Oymak O, Utas C. Levofloxacin-induced delirium: is it a dangerous drug in patients with renal dysfunction?. Renal failure. 2012;34(5):634-636. https://doi.org/10.3109/0886022x.2012.660855
- Veličković-Radovanović R, Catić-Đorđević A, Dinić K, Radivojević J, Žikić O, Cvetković T, Mitić B. Metronidazole-and levofloxacin-induced psychotic disorders in chronic kidney patient. European Journal of Hospital Pharmacy. 2019;26(6):347-349. https://doi.org/10.1136/ejhpharm-2018-001677
- Lertxundi Unax, Palacios Hernandez Rafael, Gutierrez Cibrian Fernando, Domingo-Echaburu Saioa, Garcia Garcia Monserrat and Gomez Aguirre Carmelo, Levofloxacin-Induced Delirium in a Patient Suffering from Schizoaffective Disorder and Multiple Sclerosis, Current Drug Safety 2013; 8 (3). https://dx.doi.org/10.2174/15748863113089990043
- Takser L, Grad R. Acute psychotic symptoms following a single dose of levofloxacin. Clinical Case Reports. 2017;5(12):2136. https://doi.org/10.1002/ccr3.1240
- Akahane K, Tsutomi Y, Kimura Y, Kitano Y. Levofloxacin, an optical isomer of ofloxacin, has attenuated epileptogenic activity in mice and inhibitory potency in GABA receptor binding. Chemotherapy. 1994;40(6):412-417. https://doi.org/10.1159/000239301
- Bellon A, Perez-Garcia G, Coverdale JH, Chacko RC. Seizures associated with levofloxacin: case presentation and literature review. European journal of clinical pharmacology. 2009;65(10):959-962. https://doi.org/10.1007/s00228-009-0717-5
- Hansen N, Rediske AI. The Locus Coeruleus Noradrenaline System in Delirium. Frontiers in Aging Neuroscience. 2021;13. https://doi.org/10.3389%2Ffnagi.2021.784356
Published
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Medicine and Dentistry
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the CreativeCommons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/