Can Antibiotics Induce Psychiatric Reactions?

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Lisa Bloomquist
In Stephen Fried’s 1998 book, “Bitter Pills: Inside the Hazardous World of Legal Drugs” he describes his wife Diane’s severe adverse reaction to a fluoroquinolone antibiotic, floxin (ofloxacin). Diane became bipolar after taking floxin to treat a urinary tract infection. She also suffered from delirium, visual distortions, insomnia and other central nervous system and psychiatric issues after taking floxin, an antibiotic. This drug is in the same class and has the same mechanism of action as cipro/ciprofloxacin, levaquin/levofloxacin and avelox/moxifloxacin; together they are some of the most popular antibiotics in the United States (26.9 million prescriptions for fluoroquinolones were written in 2011 alone).

Diane was not bipolar before she took floxin. She was bipolar after she took it. Floxin CAUSED Diane to become bipolar.

What??? How does that happen? That’s not possible, is it? It can’t be possible. Antibiotics can’t lead to serious psychiatric illness, can they?

Not all antibiotics can, but fluoroquinolones most definitely can, and do, cause many central nervous system and  psychiatric problems, including, but not limited to: seizures, dizziness, confusion, tremors, hallucinations, depression, psychosis, suicidal ideation or thoughts, insomnia, memory loss, loss of reading comprehension, inability to concentrate, bipolar disorder, extreme anxiety, and more. Every one of the neuro-psychiatric symptoms listed has been reported as a long-lasting adverse effect of fluoroquinolones in many of those suffering from fluoroquinolone toxicity. A couple of recent studies reveal how fluoroquinolones can lead to long-lasting psychiatric illnesses.

Mitochondrial Damage, Oxidative Stress and Lipid Peroxidation in Bipolar Disorder

In “Lipid Peroxidation in Psychiatric Illness: Overview of Clinical Evidence” it is noted that, “While its underlying pathophysiology remains multifaceted and elusive, recent data have indicated that mitochondrial dysfunction and aberration in oxidation status are important components of bipolar disorder.” It is noted that indicators of mitochondrial dysfunction and oxidative stress, such as thiobarbituric acid, malondialdehyde, and carbonylation and nitration of cells have been found in the brains of people with bipolar disorder. Additionally, catalase, glutathione peroxidase and lipid peroxidation levels are abnormal in patients with bipolar disorder. The cellular processes that regulate oxidative stress and lipid peroxidation are not working properly in people suffering from bipolar disorder. “The brain is known to be sensitive to oxidative stress and lipid peroxidation” and when oxidative stress and lipid peroxidation are occurring at unhealthy levels in the brain, serious psychiatric diseases can result. (Schizophrenia, major depressive disorder and attention deficit hyperactivity disorder are noted, in addition to bipolar disorder. Each of these psychiatric illnesses are related to oxidative stress and lipid peroxidation.)

Mitochondrial Damage, Oxidative Stress and Lipid Peroxidation caused by Fluoroquinolone Antibiotics

In a 2011 article entitled “Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients” it is noted that, “There is significant and gradual elevation of lipid peroxide levels in patients on ciprofloxacin (3.6 ± 0.34 nmol/ml to 6.2 ± 0.94 nmol/ml) and levofloxacin (3.5 ± 0.84 nmol/ml to 5.1 ± 0.28 nmol/ml).” Additionally, it was found that “There was substantial depletion in both SOD (superoxide dismutase) and glutathione levels particularly with ciprofloxacin.” As lipid peroxide levels increase, and SOD and glutathione levels decrease, reactive oxygen species (ROS) – which cause oxidative stress – build up and cause hugely deleterious effects on all areas of human health – including, but not limited to, mental health.

In “Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells” it is noted that ciprofloxacin, a fluoroquinolone, as well as a couple other bactericidal antibiotics (but not bacteriostatic antibiotics like tetracyclines), “induced dose and time-dependent increases in intracellular ROS (reactive oxygen species) in various human cell lines.”

The Vicious Cycle of Mitochondrial Damage and Oxidative Stress

When mitochondria are damaged past their tolerance threshold, an over-abundance of ROS/cellular oxidative stress is produced and the “vicious cycle” of mitochondrial damage and oxidative stress is initiated. Mitochondrial damage causes oxidative stress, oxidative stress further damages mitochondria, damaged mitochondria produce more oxidative stress which further damages mitochondria – and so on, and so on. Therefore, diseases that are related to mitochondrial damage and oxidative stress are chronic in nature, and when a pharmaceutical causes mitochondrial damage and oxidative stress, the effects of the pharmaceutical are not transient or stopped when administration of the drug has stopped. They can be long-lasting – sometimes permanent.

Fluoroquinolone antibiotics have been shown to damage mitochondria and lead to both an increase in lipid peroxidation, oxidative stress and a decrease in antioxidants that mitigate oxidative stress. The brain is sensitive to mitochondrial damage, oxidative stress and lipid peroxidation. Bipolar disorders, and other severe psychiatric illnesses, are linked to mitochondrial damage and oxidative stress.

THAT is how Floxin caused Diane to get lost in her closet and receive a diagnosis of bipolar disorder.

She was not bipolar before she took Floxin. She was after she took Floxin. Floxin caused mitochondrial damage and oxidative stress, which led to deleterious effects on her brain and psychiatric illness.

Recognizing the Connection between Fluoroquinolone Antibiotics and Psychiatric Illness

Of course, not everyone who takes a fluoroquinolone antibiotic ends up with a psychiatric illness. But many people do and very few of them have any clue that their mental problems (including anxiety, depression, insomnia, etc. as well as more severe psychiatric illnesses) are connected with the prescription antibiotic that they took to treat a simple urinary tract or sinus infection. The delayed reactions and tolerance thresholds that come along with pharmaceutical induced mitochondrial damage and oxidative stress make the connection between the cause – cipro, levaquin, avelox and/or floxin, and the effect – mental illness, difficult.

Psychiatric Illness Paradigms Need to be Adjusted

In addition to fluoroquinolones, statins, metformin, acetaminophen and all psychotropic drugs have been shown to cause mitochondrial damage and oxidative stress, which has been linked to many psychiatric illnesses. Rather than looking at how pharmaceuticals affect mitochondria and/or oxidative stress, or how any of those things affect the brain, psychiatrists have been stuck on outdated notions of psychiatric illness. “Although different psychiatric disorders are currently thought to stem from unique abnormalities in neuronal biochemistry, circuitry, and/or brain architecture, emerging data indicates that oxidative stress is present and may play an active role in these psychiatric illnesses.” If it was acknowledged that mitochondrial damage and oxidative stress were causally related to psychiatric disorders, and all chronic diseases (including chronic fatigue syndrome, fibromyalgia, retinitis pigmentosa, diabetes, obesity, etc., along with psychiatric illnesses) perhaps some M.D.s would think twice before prescribing drugs that damage mitochondria and led to oxidative stress.

They should start with thinking twice about prescribing fluoroquinolone antibiotics. Bitter Pills was a bestseller in 1998. Sixteen years has passed, perhaps it’s time to pay attention.

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site,

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

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  1. Just stumbled on this old thread but I’m glad I did. I thought I was the only one who had experienced this!
    I was prescribed Levaquin for a infected tooth and almost immediately I thought I had gone crazy!…no, I mean literally insane. Could not lay or sit still. Couldn’t sleep. Being dressed felt like I was in a straight jacket. Having even just a sheet over me was like being buried alive. I almost ripped my knuckle off in the middle of the night because I HAD to get my wedding ring off!
    They quickly switched antibiotics but some of the symptoms hung around for a long time to some degree.
    e.g.: it was over six months before I could wear my wedding ring again.
    I described this to the dentist and later to my regular Physician and they both looked at me like I was crazy without any drugs. Lol! They had never heard of that kind of reaction.

  2. I was on cipro for a UTI and had a lot of problems from taking it. My question for anyone is I need advice on what to take when I get a UTI, I’m afraid to take antibiotics but my UTIs won’t go away without one and I have just developed another UTI unfortunately. Any advice would be appreciated. I’ve tried the natural way and it didn’t work. I really need an antibiotic but I’m scared. Is there anything out there that has worked for someone who has been floxed? Thank you

  3. Hello, I don’t know if this is still an active page, but hoping so. My mother went to after hours clinic for a basic UTI about a month ago and they prescribed her cipro…she was on it for nearly 10 days then was having severe issues (double vision, head pressure)..she then started having upper GI issues…so her doctor then put her on a Prevpac for H. Pylori (I am still not convinced it was active HP)…she was on Prevpac for like 6-7 days and asked to come off of it..but dr said now and a few days ago started expressing mania…I am terrified that this is from the Cipro and Clarithromycin in the Prevpac.
    Can anyone offer any advice for detoxing? Is this permanent? My mother has never had any issues her entire 67 years on this earth and now I am seeing her go through hell.

  4. Psychotic problems hit me all at once after treatment for UTI. I had read about issues concerning tendons, but not the attacks on mental health. Have been given Cipro several times and have reported cognitive issues to my Dr. However this last time I was hit both physically and felt that I was going insane overnight. I tell Dr.’s that I am hypersensitive to Many medicines and have the adverse effects…And while at hospital in Nov. 2015, my Dr. said he would send me home with Non Quinolone anti biotic… also had injection while in hospital. I have gone thru hell…and now I see that my symptoms are being ignored. Two weeks ago my Dr. told me he thought the drama of having two blood transfusions in hospital must have triggered this ongoing Confusion, memory loss, anxiety and panic attacks. Insomnia. Plus nearly every one of my medicines seem to suddenly make it worse. Now I have read that this is also one of the symptoms of toxicity.

  5. Hi my Brother in law has recently come through a staph infection and was on intraveneous antibiotics for 6 weeks followed by some oral ones. He suffers from bipolar already, but hasn’t had a manic episode for a long time. almost immediately as he was finished treatment he has been hit with a manic episode. If you have any information on the possible connection between the two events, and possible drugs he might have been prescribed, please share anything you might have. We are trying to get him help, and avoid it happening again. thank you for your article, ~ Paula

    1. Hi Paula,

      I am very sorry to hear that your brother in law is suffering from mania after antibiotic exposure!

      I believe that fluoroquinolone antibiotics damage mitochondria which leads to a massive amount of oxidative stress, which leads to mast cell activation, which leads to many illnesses, including psychiatric illnesses. I suggest supplements and a diet that supports mitochondria, reduces oxidants and de-activates mast cells.

      Here is a post about how fluoroquinolones can activate mast cells – If you look through the other posts I’ve written on this site, you can find information about how they affect mitochondria too.

      Many people have been helped by MitoQ – it is the mitochondrial support / antioxidant supplement that people have found to be the most helpful.

      Neuroprotek, a mast cell stabilizing supplement developed by Dr. Theoharides, may help too. Here is information on it –

      I also suggest meditation and getting him into a calm, peaceful environment in order to help reduce inflammation.

      I hope that helps!


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