{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:31:51Z","timestamp":1785411111249,"version":"3.56.0"},"reference-count":14,"publisher":"Medicinska Naklada d.o.o.","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Metronidazole, a widely used antimicrobial agent, has been associated with rare neuropsychiatric adverse effects, including antibiotic-induced mania (antibiomania). We report the case of a 46-year-old woman with a history of bipolar disorder type I, previously triggered by antidepressant treatment, who presented with an acute onset of a manic episode with psychotic features following prolonged\nmetronidazole treatment. The patient had remained euthymic and medication-free for approximately nine years prior to this episode.\nMetronidazole was discontinued upon admission, and appropriate psychiatric treatment was initiated. Manic and psychotic symptoms\nresolved completely within three days, supporting a probable causal association. This case highlights the potential of metronidazole to\ninduce manic episodes, particularly in individuals with a predisposition to mood disorders, and aims to discuss the possible underlying\nmechanisms through which metronidazole may contribute to the development of mania.<\/jats:p>","DOI":"10.24869\/psyd.2026.80","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:48:31Z","timestamp":1778176111000},"page":"80","source":"Crossref","is-referenced-by-count":0,"title":["Psychotic mania induced by metronidazole: A rare case of antibiomania"],"prefix":"10.24869","volume":"38","author":[{"given":"Bilge","family":"Targ\u0131tay \u00d6zt\u00fcrk","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00dbd8b73","id-type":"ROR","asserted-by":"publisher"}],"name":"Dokuz Eyl\u00fcl University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf","family":"Tinga","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00dbd8b73","id-type":"ROR","asserted-by":"publisher"}],"name":"Dokuz Eyl\u00fcl University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"G\u00fcl Da\u011flar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00dbd8b73","id-type":"ROR","asserted-by":"publisher"}],"name":"Dokuz Eyl\u00fcl University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6768","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1. Abouesh, A., Stone, C., & Hobbs, W. R. (2002). Antimicrobial-induced mania (antibiomania): a review of spontaneous reports. Journal of Clinical Psychopharmacology, 22(1), 71\u201381. https:\/\/doi.org\/10.1097\/00004714-200202000-00012","DOI":"10.1097\/00004714-200202000-00012"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"2. Ahmed, A., Loes, D. J., & Bressler, E. L. (1995). Reversible Magnetic Resonance Imaging Findings in metronidazole-induced Encephalopathy. Neurology, 45(3), 588\u2013589. https:\/\/doi.org\/10.1212\/WNL.45.3.588","DOI":"10.1212\/WNL.45.3.588"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"3. AlShakori, M., Arain, S. I., Thorakkattil, S. A., & Abdulkader, S. (2022). Exacerbation of Mania due to Metronidazole in a Bipolar Disorder Patient. Case Reports in Psychiatry, 2022, 3748101. https:\/\/doi.org\/10.1155\/2022\/3748101","DOI":"10.1155\/2022\/3748101"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"4. Althubyani, A. A., Canto, S., Pham, H., Holger, D. J., & Rey, J. (2024). Antibiotic-induced neuropsychiatric toxicity: epidemiology, mechanisms and management strategies \u2013 a narrative literature review. Drugs in Context, 13. https:\/\/doi.org\/10.7573\/dic.2024-3-3","DOI":"10.7573\/dic.2024-3-3"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"5. Befani, O., Grippa, E., Saso, L., Turini, P., & Mondov\u00ec, B. (2001). Inhibition of monoamine oxidase by metronidazole. Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.], 50 Suppl 2, S136-7. https:\/\/doi.org\/10.1007\/PL00022395","DOI":"10.1007\/PL00022395"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"6. Chan, Y.-C. (2023). Metronidazole-Induced Mania. The Primary Care Companion for CNS Disorders, 25(3). https:\/\/doi.org\/10.4088\/PCC.22cr03408","DOI":"10.4088\/PCC.22cr03408"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"7. Dinan, K., & Dinan, T. (2022). Antibiotics and mental health: The good, the bad and the ugly. Journal of Internal Medicine, 292(6), 858\u2013869. https:\/\/doi.org\/10.1111\/joim.13543","DOI":"10.1111\/joim.13543"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"8. Jimenez-Fernandez, S., Solis, M. O., Martinez-Reyes, I., Alvarado-Dafonte, A., Soldado-Rodriguez, L., & Rodriguez-Natal, M. I. (2021). Secondary mania in an elderly patient during SARS-COV-2 infection with complete remission; A 1-year follow-up. Psychiatria Danubina, 33(3), 418\u2013420. https:\/\/doi.org\/10.24869\/psyd.2021.418","DOI":"10.24869\/psyd.2021.418"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"9. Khandheria, M., Snook, E., & Thomas, C. (2014). Psychotic episode secondary to metronidazole use. General Hospital Psychiatry, 36(2), 231.e3-4. https:\/\/doi.org\/10.1016\/j.genhosppsych.2013.11.009","DOI":"10.1016\/j.genhosppsych.2013.11.009"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"10. Kivlichan, A. E., Praecht, A., Wang, C., & George, T. P. (2024). Substance-Induced Mood Disorders: A Scoping Review. Current Addiction Reports, 11(1), 1\u201318. https:\/\/doi.org\/10.1007\/s40429-023-00533-z","DOI":"10.1007\/s40429-023-00533-z"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"11. Neufeld, N. H., Mohamed, N. S., Grujich, N., & Shulman, K. (2017). Acute Neuropsychiatric Symptoms Associated With Antibiotic Treatment of Helicobacter Pylori Infections: A Review. Journal of Psychiatric Practice, 23(1), 25\u201335. https:\/\/doi.org\/10.1097\/PRA.0000000000000205","DOI":"10.1097\/PRA.0000000000000205"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"12. Parker, G., & Russo, N. (2025). Antibiomania: An update. Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists, 33(5), 797\u2013799. https:\/\/doi.org\/10.1177\/10398562251370946","DOI":"10.1177\/10398562251370946"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"13. Peet, M., & Peters, S. (1995). Drug-induced mania. Drug Safety, 12(2), 146\u2013153. https:\/\/doi.org\/10.2165\/00002018-199512020-00007","DOI":"10.2165\/00002018-199512020-00007"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"14. Puri, P., Parnami, P., Chitkara, A., Athwal, P. S. S., & Khetrapal, S. (2021). Antibiomania: A Rare Case of Metronidazole-Induced Mania. Cureus, 13(1), e12414. https:\/\/doi.org\/10.7759\/cureus.12414","DOI":"10.7759\/cureus.12414"}],"container-title":["Psychiatria Danubina"],"original-title":[],"link":[{"URL":"https:\/\/www.psychiatria-danubina.com\/UserDocsImages\/pdf\/dnb_vol38_no1\/dnb_vol38_no1_80.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:48:37Z","timestamp":1778176117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.psychiatria-danubina.com\/UserDocsImages\/pdf\/dnb_vol38_no1\/dnb_vol38_no1_80.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,4,30]]},"published-print":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.24869\/psyd.2026.80","relation":{},"ISSN":["0353-5053","1849-0867"],"issn-type":[{"value":"0353-5053","type":"print"},{"value":"1849-0867","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}