Can antibiotics effect mental status?

Philip Copitch, Ph.D. – Author of Change: How to bring real change to your life: The psychology and secrets of highly effective people

An interesting report crossed my desk today. It was published in MedScape Psychiatry.

Antibiotics and Mental Status Changes

All medication can potentially change your mental status, the way you think, feel, or react. In this article, pharmacists from Albany Medical Hospital, Albany NY review this question.

They point out:

Any change in mental status should always prompt a review of medications as a potential contributing factor. Antimicrobials, a drug class that is an often-overlooked etiology, have been associated with a wide range of neurologic symptoms, including sedation, sleep disturbance, confusion, delirium, seizures, mood changes, psychosis, and hallucinations.

A chart of drugs and risk factors is included.

Read the report

Antidepressant drugs and drug-induced liver injury

Philip Copitch, Ph.D.

Author of Change: How to bring real change to your life: The psychology and secrets of highly effective people

The American Journal of Psychiatry reports

December 2013, researchers reported in The American Journal of Psychiatry that common antidepressant drugs can cause liver damage in humans. Drug-induced liver injury (DILI) was found in 0.05-3.0% of those taking antidepressants.

The researchers did a PubMed review from 1965 to the present, and reported that all antidepressants can induce hepatotoxicity (liver cell damage or destruction), especially in elderly patients or patients taking multiple prescription medications. This chemically driven cell damage was found to be unrelated to drug dosage and generally occurred between several days and 6 months of starting the medication. 

The antidepressants associated with greater risks of damaging the liver are:

• iproniazid
• nefazodone
• phenelzine
• imipramine
• amitriptyline
• duloxetine
• bupropion
• trazodone
• tianeptine
• agomelatine

The antidepressants that seem to have the least potential  to damage the liver are 

• citalopram
• escitalopram
• paroxetine
• fluvoxamine

The researchers conclude:

Although an infrequent event, DILI from antidepressant drugs may be irreversible, and clinicians should be aware of it.