Reeves R R
Department of Psychiatry and Behavioral Sciences, University of Oklahoma College of Medicine-Tulsa 74129.
Ann Pharmacother. 1992 Jul-Aug;26(7-8):930-1. doi: 10.1177/106002809202600716.
To report a case of ciprofloxacin-induced psychosis and to discuss occurrence rates, risk factors, possible etiologies, preventive measures, and treatment courses for this adverse reaction.
Case reports and review articles identified by MEDLINE.
Data from pertinent published sources were reviewed and abstracted.
A 49-year-old man developed symptoms of severe psychosis concomitant with ciprofloxacin (250 mg bid) treatment. Central nervous system effects secondary to ciprofloxacin treatment are uncommon and usually consist only of minor dizziness or mild headache, although rare occurrences of seizures and hallucinations have been reported. The mechanism by which ciprofloxacin causes these adverse effects is not fully understood. It has been suggested that quinolones may produce an epileptogenic effect by inhibiting the binding of gamma-aminobutyric acid to its receptor sites in the brain. There is yet no explanation for the occurrence of hallucinations or psychosis.
Caution should be exercised when using ciprofloxacin in the treatment of patients with personality abnormalities or symptoms of psychosis.
报告1例环丙沙星诱发精神病的病例，并探讨该不良反应的发生率、危险因素、可能病因、预防措施及治疗过程。
通过MEDLINE检索到的病例报告和综述文章。
对相关已发表文献的数据进行回顾和摘要。
一名49岁男性在接受环丙沙星（250毫克，每日两次）治疗时出现了严重精神病症状。环丙沙星治疗继发的中枢神经系统效应并不常见，通常仅表现为轻微头晕或轻度头痛，不过也有罕见的癫痫发作和幻觉的报道。环丙沙星导致这些不良反应的机制尚未完全明确。有人提出，喹诺酮类药物可能通过抑制γ-氨基丁酸与大脑中其受体位点的结合而产生致癫痫作用。目前对于幻觉或精神病的发生尚无解释。
在使用环丙沙星治疗有个性异常或精神病症状的患者时应谨慎。
