Psychiatr. praxi. 2026;27(2):112-114 | DOI: 10.36290/psy.2026.019

Clarithromycin induced mania with psychotic symptoms

MUDr. Dominik Korený1, 2, MUDr. Věra Šantrůčková1, 3
1 Psychiatrická nemocnice Bohnice, Praha
2 1. lékařská fakulta Univerzity Karlovy, Praha
3 Psychiatrická ambulance, Praha

Clarithromycin is a widely used antibiotic known for its broad-spectrum antimicrobial activity, but it has some psychiatric side effects that are rare but can be serious. This article presents a case report when clarithromycin, a commonly prescribed macrolide antibiotic, was implicated in the development of mania with psychotic symptoms in a previously psychiatrically naive patient.

Keywords: clarithromycin, mania with psychotic symptoms, antibiomania.

Accepted: June 10, 2026; Published: July 21, 2026  Show citation

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Korený D, Šantrůčková V. Clarithromycin induced mania with psychotic symptoms. Psychiatr. praxi. 2026;27(2):112-114. doi: 10.36290/psy.2026.019.
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References

  1. Alan BE, Akarçay S, Çelik YS. Clarithromycin induced psychotic disorder with catatonic-like features in an adolescent girl: Case report (eng). Klinik Psikiyatri Dergisi. 2022;25(2):234-7. Go to original source...
  2. Carrasco JP, Aguilar EJ. Antibiomania: A Case Report of a Manic Episode Potentially Induced by the Interaction of Clarithromycin and Amoxicillin during. Actas Esp Psiquiatr. 2024 Feb;52(1):57-59.
  3. Honzák R, Strunzova V, Janouskova L, et al.Case Report Antibiomania: Clarithromycin-Induced Mania? Acta Psychopathol. 2015;1:9. doi: 10.4172/2469-6676.10009. Go to original source...
  4. Whittam D, Matthews R, Nimeri R, et al. Antibiomania: Clarithromycin-induced neurotoxicity mimicking autoimmune limbic encephalitis. Pract Neurol. 2024 Jun 1;24(3):226-30. Go to original source...
  5. Marković T, Todorović A, Stojković M, et al. Antibiomania: A Systematic Review of Clarithromycin-Associated Manic Episodes. J Clin Psychopharmacol. 2026;46(1). Available from: https://journals.lww.com/psychopharmacology/fulltext/2026/01000/antibiomania__a_systematic_review_of.12.aspx. Go to original source... Go to PubMed...
  6. Meszaros EP, Stancu C, Costanza A, et al. Antibiomania: a case report of clarithromycin and amoxicillin-clavulanic acid induced manic episodes separately. BMC Psychiatry. 2021 Dec 1;21(1):399. Go to original source...
  7. Bichler EK, Elder CC, García PS. Clarithromycin increases neuronal excitability in CA3 pyramidal neurons through a reduction in GABAergic signaling. J Neurophysiol. 2017;117:93-103. Go to original source...
  8. Michaelis L, Berg L, Maier L. Confounder or Confederate? The Interactions Between Drugs and the Gut Microbiome in Psychiatric and Neurological Diseases. Biological Psychiatry. Elsevier Inc.; 2024;95:361-9. Go to original source... Go to PubMed...
  9. Cipil A, Kiraz S, Erolu MZ, Göndöz A. Helicobacter pylori eradication pharmacotherapy induced psychotic episode. Psychiatr Danub. 2021;33(2):185-6. Go to original source...
  10. Lally L, Mannion L. The potential for antimicrobials to adversely affect mental state. BMJ Case Rep. 2013 Jul 5:2013:bcr2013009659. doi: 10.1136/bcr-2013-009659. Go to original source...
  11. Abouesh A, Hobbs W. Clarithromycin-Induced Mania. Am J Psychiatry. 1998 Nov;155(11):1626. doi: 10.1176/ajp.155. 11. 1626. Go to original source...
  12. Arain SI, Al Shakhori M, Thorakkattil SA, et al. Acute Psychotic Episode Induced by Antimicrobial Treatment. Case Rep Psychiatry. 2023;2023:9996763. Go to original source... Go to PubMed...
  13. Althubyani AA, Canto S, Pham H, et al. Antibiotic-induced neuropsychiatric toxicity: epidemiology, mechanisms and management strategies - a narrative literature review. Drugs Context. 2024 Jul 24:13:2024-3-3. doi: 10.7573/dic.2024-3-3. eCollection 2024. Go to original source...
  14. Miñambres A, Cuevas-Esteban J, Pardo M, et al. Antibiomania after triple therapy for Helicobacter Pylori: Two case reports and a review of physiopathology. Eur. J. Psychiat. 2014;28(2). https://dx.doi.org/10.4321/S0213-61632014000200003. Go to original source...
  15. Khallouk A, Stati S, Boukdir A, et al. Antibiomania: A Case Report of Amoxicillin Clarithromycin and Metronidazole Induced Manic Episode. Scholars Journal of Medical Case Reports. 2025 Jan 16;13(01):118-20. Go to original source...




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