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.
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.
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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.
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Who cites it
1 citing paper in PubMed.
- Metronidazole-associated mood changes: A case report.Exploratory research in clinical and social pharmacy · 2026Article
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8 authors.
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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.
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