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喹诺酮类药物引起的精神病:最新综述。

Quinolone-induced psychosis: an updated review.

机构信息

Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron. Barcelona. España Grupo de Psiquiatría, Salud Mental y Adicciones, Vall d'Hebron Research Institute (VHIR). Barcelona. España Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona. España Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona. Barcelona. España.

Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron. Barcelona. España.

出版信息

Actas Esp Psiquiatr. 2020 May;48(3):126-37. Epub 2020 May 1.

Abstract

Quinolones are an antibiotic group widely used due to their antimicrobial action and security profile, however, it has been described neuropsychiatric adverse effects, being induced-psychotic episodes one of the most clinically relevant. Nevertheless, this secondary effect has been scarcely studied. A literature search using PRISMA guidelines was performed between 01/01/1962 and 01/31/2019 on PubMed and ScienceDirect, including manuscripts which described substance-induced psychotic disorder according to DSM-5 and in which the symptomatology was not attributable to an acute confusional state (delirium) or to other induced psychiatric disorders. 459 articles were found, but only 27 manuscripts fulfilled inclusion criteria (n=27 patients, median age of 36.15±16.96 years). Ciprofloxacin, levofloxacin and ofloxacin were the main antibiotics implicated. Quinolone- induced psychosis is a clinical relevant issue due to the high prescription of these antibiotics and the severity of this clinical syndrome. In general, this syndrome can remit in a few days with the withdrawal of the quinolone and performing symptomatic support if it is necessary. Finally, it is important to perform further research on this issue. Keywords: Quinolones, Psychosis, Ciprofloxacin, Levofloxacinn, Psychotic Induced.

摘要

喹诺酮类是一类广泛应用的抗生素,由于其抗菌作用和安全性,然而,它已被描述为神经精神不良反应,诱导精神病发作为最具临床相关性的之一。尽管如此,这种次要作用的研究还很少。根据 PRISMA 指南,我们在 PubMed 和 ScienceDirect 上进行了 1962 年 1 月 1 日至 2019 年 1 月 31 日的文献检索,包括描述根据 DSM-5 诊断的物质诱导性精神病障碍的文献,且症状不能归因于急性意识混乱(谵妄)或其他诱导性精神障碍。共发现 459 篇文章,但只有 27 篇手稿符合纳入标准(n=27 例患者,中位年龄 36.15±16.96 岁)。环丙沙星、左氧氟沙星和氧氟沙星是主要的抗生素。由于这些抗生素的高处方率和这种临床综合征的严重程度,喹诺酮类诱导的精神病是一个具有临床相关性的问题。一般来说,在停用喹诺酮类药物并进行对症支持治疗后,这种综合征可在几天内缓解。最后,对这个问题进行进一步的研究是很重要的。关键词:喹诺酮类、精神病、环丙沙星、左氧氟沙星、诱导性精神病。

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