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Psychiatric Side Effects of Fluoroquinolone Antibiotics

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In a survey of 94 people who experienced adverse reactions to Levaquin/levofloxacin, a fluoroquinolone antibiotic, 72% reported experiencing anxiety, 62% reported depression, 48% reported insomnia, 37% reported panic attacks, 33% reported brain fog and/or cognitive impairment, 29% reported depersonalization and/or derealization, 24% reported thoughts of suicide and 22% reported psychosis.  Case-studies and research papers also reveal that fluoroquinolone antibiotics can cause severe psychiatric adverse reactions.  Some of the studies include, Acute Psychosis Following the Use of Topical Ciprofloxacin, A Possible Case of Levofloxacin Associated Amnesia, Depression, and Paresthesia, Levofloxacin-induced acute psychosis, Ofloxacin-induced hallucinations, and others.  Fluoroquinolone antibiotics, Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin, can cause severe psychiatric adverse reactions. These psychiatric adverse reactions, like other adverse reactions to fluoroquinolones that are encompassed in fluoroquinolone toxicity syndrome, can be long-lasting and are sometimes permanent.

Petitioning the FDA about Fluoroquinolone Safety

A citizen petition has been submitted to the U.S. Food and Drug Administration (FDA) requesting that increased warnings about the severe psychiatric effects of Levaquin/levofloxacin be added to the official warning labels. The petition, which was submitted by Dr. Charles Bennett of the Southern Network on Adverse Reactions (SONAR), requests that a black box warning about serious psychiatric adverse events be added to the Levaquin/levofloxacin warning label. Black box warnings are the “strongest warning that the FDA requires, and signifies that medical studies indicate that the drug carries a significant risk of serious or even life-threatening adverse effects.”

Psychiatric Side Effects of Fluoroquinolone Antibiotics: From the Survivors

The psychiatric adverse effects of fluoroquinolones are severe, life-altering and sometimes life-threatening. People with no history of psychiatric problems have experienced depression, paranoia, psychosis, anxiety, etc. after taking fluoroquinolone antibiotics. Traci describes the effects of Cipro on her mental and physical health as follows:

“It has almost been 3 years since I took a 30 day supply of Cipro for a UTI and just like most of the stories, my life has changed drastically. First came the weakness and fatigue, enough to where I would sleep for days and started wrapping my wrists, arms and feet with k tape on a daily basis. My eye sight started going bad very quickly, and just constant tingling, numbness, brittle, depression that I couldn’t control, loss of balance, anxiety, panic attacks, insomnia that lasted for days at a time, nightmares.

I’ve  lost a couple of years with my children and husband that I will never get back. I left a very good job/company thinking stress was the cause and went to another smaller company only to get let go a few months after starting as I couldn’t make it to work every day.

My first doctor seemed angry when I asked her if the Cipro could be the cause and made me feel like an idiot. I went to holistic doctor, didn’t mention the Cipro this time as I thought I was wrong about the cause. She diagnosed me with fibromyalgia  and chronic fatigue syndrome and wanted to run tests to find toxins in my system, but due to job loss I could no longer afford. She was on the right track and I’m grateful for the things she has taught me in my short time with her, but I am still down more days than I am up and I lost a really good salary that has put pressure on my whole family. Finally when I heard FDA announced the link to peripheral neuropathy and started reading about what Cipro has done to others I at least know I am not crazy.”

Traci’s story of multiple psychiatric symptoms, including depression, anxiety and panic attacks, and the effects of those symptoms on her life, are unfortunately familiar for many people who have taken fluoroquinolones. Another victim of Cipro/ciprofloxacin, Ruth, reported:

“A couple days after stopping the Cipro, I experienced terrifying panic attacks every time I fell asleep. It was like being shoved down into hell: a place of loneliness and terror. I had never felt fear and hopelessness like that. It was like being thrust into a horrible place from which there was no escape.”

The adverse psychiatric effects of fluoroquinolones can seem to come out of nowhere, with panic and anxiety attacks striking while doing normal activities like watching television, driving, or falling asleep. Adverse reactions to fluoroquinolones are often delayed for weeks or even months after administration of the drugs has stopped; leaving victims and physicians alike with difficulty connecting the drugs to the ensuing psychiatric problems.

Serious and Life Altering Psychiatric Side Effects

The psychiatric symptoms described by Traci and Ruth are serious and life-altering. Neither physicians nor patients currently have adequate information about the severity of adverse psychiatric effects caused by fluoroquinolone antibiotics because the psychiatric effects are currently buried in the “Central Nervous System Effects” heading of the warning label. As the citizen petition notes, these effects should have their own heading and a black box warning. Perhaps when a black box warning of serious psychiatric events is added to the warning labels for Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin it will be realized that people who are suddenly suffering from panic and anxiety attacks, insomnia, paranoia, excessive fearfulness, psychosis, bipolar disorder, etc. after taking a fluoroquinolone aren’t suddenly crazy or deciding to be difficult, they’re suffering from fluoroquinolone toxicity syndrome – an iatrogenic disease and a tragic assault to victims’ bodies and minds.

I hope that the FDA responds to Dr. Bennett and SONAR’s call for increased warnings about the psychiatric effects of fluoroquinolones by both adding the warnings requested, and by restricting the rampant use of fluoroquinolones when other, safer, antibiotics are available. Loss of mental health is not an appropriate price to pay for treatment of a urinary tract infection, traveler’s diarrhea, sinus infection or any other infection that isn’t life-threatening.

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, www.floxiehope.com.

Postpartum Fluoroquinolone Toxicity

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In March of 2011, two months after the birth of my daughter, I experienced a bout of acute illnesses. My birth experience had been difficult, delivering five weeks early via emergency C-section after my water broke at 35 weeks gestation. My recovery was complicated by the need for an appendectomy just six weeks later. As if two abdominal surgeries weren’t enough, all of the trauma apparently dislodged two kidney stones in my right kidney. I woke up one morning with blinding pain in my stomach that migrated to my back and my side. I had passed a kidney stone once before, so I immediately knew what was causing the pain. Many who have experienced a kidney stone compare it to the pain of childbirth; I would argue that the pain is actually much worse. Unable to manage the pain on my own, I was taken to the emergency room for treatment. In the ER I was given IV pain medication and sent home with a short-term prescription for hydrocodone. I was also sent home with a prescription for a seven day course of the antibiotic Cipro. This medication was given to me as a preventative measure in case the stone ripped through my ureter.

Initial Symptoms of an Impending Cipro Reaction

About 48 hours after beginning the Cipro, I noticed an unusual feeling of nervousness. I was also having trouble regulating my internal body temperature. I would either be sweating profusely or so bone-chill cold that the only relief I could get was standing in a hot shower. I attributed these symptoms to being overwhelmed by the beating my body had taken in the last two months all while trying to care for my two month old preemie daughter. The anxiety was met with severe insomnia, and after a few days of almost complete sleeplessness (on top of the getting up with a newborn every few hours), I saw a general practitioner at a local walk-in clinic to get some advice and hopefully some relief. The doctor agreed that I was likely overwhelmed by all that had happened on top of adjusting to caring for a newborn. However, she also mentioned that I should stop taking the Cipro, and that “Cipro can do funny things” to some people. I took her advice and stopped the Cipro. Within a few days I started to feel more normal, and I shrugged off the experience. Little did I know my nightmare was just beginning.

Neurocognitive Deficits and Cipro

Two weeks later I returned to work. I was staring at the computer screen working on a research project when I noticed that my vision had become blurry. I went to the bathroom and put saline drops in my eyes when I discovered that my pupils were enormous. My eyes looked completely black instead of the normal light greenish-blue hue. I decided to leave work and go home early, and I had to squint and blink furiously just to keep my car on the road. When I returned home, my husband noticed my eyes and told me to lie down. I was exhausted, yet sleep would not come.

Cipro and the Central Nervous System

In the next few months I deteriorated rapidly, suffering from extreme anxiety, muscle twitches, myoclonus jerks, sweating, chills, weakness, tendonitis in my wrists, confusion, PVC heart arrhythmia, among roughly 30 other terrifying and painful symptoms. The worst of them, by far, was the completely intractable insomnia. I would go days at a time without being able to sleep even for one minute, finally crashing for two or three broken hours, and then the cycle would repeat itself. I sought out several doctors who ran tests after test and found nothing. I was finally steered toward psychiatry, where I was diagnosed with “anxiety” and given a slew of prescription psychiatric medications. Luckily, I declined to take most of them.

Continued Deterioration and Delayed Reactions to Fluoroquinolones

Weeks went on and my symptoms did not abate. I decided to leave my job and stay at home to take care of my precious baby daughter, the only thing giving me hope or the will to keep moving forward at that point. I was simply too sick to work, and my work environment was extremely stressful during that time. I was still very confused as to what had befallen me. After months of suffering, I remembered the doctor who had advised me to stop the Cipro. One simple Google search of “Cipro side effects” opened literally thousands of pages of information, with stories exactly like mine, of delayed reactions and unexplainable, debilitating symptoms. Because the severe symptoms were delayed for weeks after I stopped the Cipro, I never attributed my symptoms to this medication. I was unfortunately unaware that close proximity of the effect was not a necessary condition for causation when it came to pharmaceutical side effects.  However, as I began to research this class of antibiotics, called fluoroquinolones, I became aware that the most severe reactions are often delayed.

Fluoroquinolone Toxicity

I saw the top expert in the medical field on fluoroquinolone adverse reactions, and he diagnosed me with fluoroquinolone toxicity syndrome after a careful assessment. Almost a year after my first symptoms appeared, I finally had a name for my suffering. It took me almost two and a half years to recover ninety percent. My recovery focused on nutrition, stress management, and the power of positive thinking. Instead of taking medications, I found a sleep psychologist and underwent CBT for insomnia, and it helped dramatically. I still have symptoms, including the PVC arrhythmia, transient insomnia and peripheral neuropathy, but I consider myself very lucky. Many individuals with fluoroquinolone toxicity are disabled for life. You can read more about fluoroquinolone (FQ) toxicity here.

The pharmaceutical companies will lead you to believe that these side effects are rare, and therefore insignificant compared to the population of people that the drugs help. However, the truth is that most medication side effects are never reported, if they are even attributed to the drug at all. In actuality, doctors are generally uninformed about the complex array of side effects that these drugs can cause and are often unwilling to attribute patients’ symptoms back to the medications that they themselves prescribe. It is unlikely that we have an accurate picture of the side effect profiles of many prescription drugs, not just fluoroquinolones. In fact, many have speculated that a variety of idiopathic illnesses such as fibromyalgia are not organic illnesses but are all manifestations of fluoroquinolone toxicity or other adverse medication reactions. Each individual tends to have a unique threshold for toxicity, so it is entirely possible to have taken these antibiotics before without trouble only to experience a severe adverse reaction the next time they are taken. Since my diagnosis, it has become my mission to educate my friends, family and the world on FQ toxicity. Knowledge is power, and sometimes it can even be life-saving.

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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