Metronidazole
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Psychosis: case report A 32-year-old woman developed psychosis after treatment with metronidazole for rosacea. The woman, who had no personal or family psychiatric history, was treated with metronidazole (250 mg) 2 tablets daily for 2 weeks. Twenty four hours after completing treatment she presented to an emergency department. The previous night she had begun laughing for no reason. She appeared worried and hardly slept, getting out of bed several times during the night with no purpose. At mid-day she telephoned her partner asking him to help her. She was in a street with which she was previously familiar but said she was lost. At consultation she appeared alert but confused, and sometimes suspicious. She maintained eye contact, with a frightened and fixed gaze. She was oriented to space, time and person. She displayed delirious ideation that was self-referencing and prejudicial, focused on her workmates. Blood and urine biochemistry tests were normal, as were toxin tests and cranial CAT scan. The woman was given lorazepam and assessed a few hours later. She did not remember what happened the previous night and mentioned she had vivid dreams. In relation to the mid-day episode, she said that while at work, her work colleagues were laughing at her and everything they were saying was about her. She felt she had to leave because it was too much for her and that when she called her partner, she was aware of where she was, but felt confused, lost and unable to go anywhere. The woman was discharged with dipotassium clorazepate. At 3-day follow up she had good contact, greater awareness of the episode and delirious ideation had cleared. During periodic followup over 6 months she remained stable, with no recurrence and treatment was stopped. Ganuza ZA, et al. Psychosis induced by metronidazole. Psiquiatria Biologica 17: 85-86, Jun 2010. Available from: URL: http://dx.doi.org/10.1016/ 803038738 j.psiq.2010.03.002 [Spanish; summarised from a translation] - Spain
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Reactions 25 Sep 2010 No. 1320
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