{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:57:24Z","timestamp":1793120244137,"version":"4.5.0"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2024,1,1]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>We describe a 64-year-old woman with relapsing encephalopathy. She initially presented with 5\u2009days of psychomotor agitation, progressing to mania, psychosis and seizures that mimicked autoimmune limbic encephalitis. During her first hospital admission, extensive investigation failed to establish the underlying cause, and she improved with antiseizure medication alone. After a month at home, she relapsed with identical symptoms, and only then did we recognise that both episodes had been provoked by clarithromycin, prescribed for <jats:italic>Helicobacter pylori<\/jats:italic> eradication. Clarithromycin-induced neurotoxicity is rarely reported but likely to be under-recognised. It usually manifests within days of starting treatment, with delirium, mania, psychosis or visual hallucinations, sometimes termed \u2018antibiomania\u2019. Seizures and status epilepticus appear to be less frequent. A full recovery is expected on stopping the medication.<\/jats:p>","DOI":"10.1136\/pn-2023-004035","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T13:25:50Z","timestamp":1706621150000},"page":"226-230","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Antibiomania: clarithromycin-induced neurotoxicity mimicking autoimmune limbic encephalitis"],"prefix":"10.1136","volume":"24","author":[{"given":"Daniel","family":"Whittam","sequence":"first","affiliation":[{"name":"Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"},{"name":"Neurology Department, Manchester Centre for Clinical Neurosciences, Salford Care Organisation, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Matthews","sequence":"additional","affiliation":[{"name":"Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, 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