DOI: https://doi.org/10.36347/sjmcr.2025.v13i01.026

Pages: 118-120

Introduction: Antibiomania is characterized by the onset of a manic episode in response to antibiotic use. Although relatively rare, this type of adverse effect is increasingly documented and primarily occurs in patients without a history of bipolar disorder. Several dozen cases have been reported in the literature, showing the emergence of manic symptoms following antibiotic administration, notably clarithromycin, which is one of the most frequently involved antibiotics. Clinical Case: We report the case of a 56-year-old patient who experienced a manic episode after receiving triple antibiotic therapy to eradicate Helicobacter pylori in the context of a gastroduodenal ulcer. Two days after starting treatment, behavioural disturbances appeared, characterized by irritability, aggressiveness, logorrhoea, insomnia, and a mystical delirium. Upon hospitalization, the patient exhibited acute delirious symptoms congruent with manic mood, such as grandiosity and psychomotor agitation. Brain magnetic resonance imaging (MRI) was normal. Antibiotic treatment was immediately discontinued, and treatment with sodium valproate (1,5g/day) and olanzapine (10 mg/day) was initiated. A rapid clinical improvement was observed, with the resolution of delusional ideas within a week. The patient returned to a euthymic state, and his treatment was maintained for preventive purposes. Discussion: This clinical case raises several questions: Are there predictors of Antibiomania? Is there a risk of recurrence of mood episodes after an episode of Antibiomania? What are the pathophysiological mechanisms that would explain this reaction? In all identified cases, discontinuation of antibiotics has been a determining factor. However, the introduction of psychotropic treatment and its duration remain uncertain. First, longitudinal follow-up would allow for the evaluation of this variable. Second, the presence of personal psychiatric history is not clearly established as a predictor of ...