Evidence map›Paper›PMID 41790508›Full record

SynthesisThe Journal of antimicrobial chemotherapy2026

Fluoroquinolones and the risk of panic attacks: a systematic review and disproportionality analysis using individual case safety reports from the FDA Adverse Event Reporting System (FAERS) database.

Keeirah Hiertika Raguram, Manroop Sidhu, Mohammad Ali Omrani, Bala Swetha Baskaran, Niaz Chalabianloo, Manik Chhabra, Hugues Sampasa-Kanyinga, Flory Tsobo Muanda

Abstract readSystematic Review
In one paragraph

Synthesis in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Metronidazole-associated mood changes: A case report.Exploratory research in clinical and social pharmacy · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Keeirah Hiertika RaguramDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Manroop SidhuDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Mohammad Ali OmraniDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.ORCID 0000-0001-6847-0699
Bala Swetha BaskaranDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Niaz ChalabianlooDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Manik ChhabraICES Western, Kidney, Dialysis & Transplantation Research Program, London, Ontario, Canada.
Hugues Sampasa-KanyingaHealthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Flory Tsobo MuandaDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.ORCID 0000-0003-4682-6564

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesFluoroquinolones are linked with increased risk of CNS adverse events, such as anxiety and depression. Recently, case reports have linked fluoroquinolone use and panic attacks. However, current evidence exploring the link between fluoroquinolone use and panic attacks remains limited and requires investigation for safe use. To systematically review the literature on fluoroquinolone use and the risk of panic attacks, and to study this association by comparing fluoroquinolones with other antibiotics using the FDA Adverse Event Reporting System (FAERS) database.

methodsMEDLINE and Embase databases were searched to identify relevant studies for systematic review. Active-comparator restricted disproportionality analyses using FAERS (2004Q1-2024Q4) were performed for ciprofloxacin, levofloxacin, and moxifloxacin compared to azithromycin and trimethoprim/sulfamethoxazole. Reporting odds ratios (ROR), proportional reporting ratios, adjusted ROR for potential confounders, and Bayesian analyses were conducted to detect safety signals for MedDRA term 'panic attack'.

resultsThe systematic review identified 12 studies (4 clinical trials, 8 publications describing 11 case reports), with the prevalence of panic attacks ranging between 0.46% and 1.76% in trials. Disproportionality analysis showed that, compared to azithromycin, fluoroquinolones were associated with a 6-fold increase in reports of panic attacks and a 12-fold increase compared to trimethoprim/sulfamethoxazole. Results were consistent across Bayesian analyses.

conclusionThe findings suggest an association between fluoroquinolones and increased risk of panic attacks, underscoring the need for validation through pharmacoepidemiological studies. Due to reliance on spontaneous reports, causal relationships cannot be determined for clinical recommendations. These results offer insights for research on CNS safety profiles of fluoroquinolones.

Indexed as

Anti-Bacterial AgentsFluoroquinolonesPanic DisorderAdverse Drug Reaction Reporting SystemsDatabases, FactualHumansUnited StatesUnited States Food and Drug AdministrationAnti-Bacterial AgentsFluoroquinolones

Identifiers

PMID41790508
PMCPMC13017743

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.