REVIEW article
Front. Pharmacol.
Sec. Neuropharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1613152
This article is part of the Research TopicWorld Schizophrenia Awareness Day: Raising Awareness and Advancing Pharmacological Strategies in SchizophreniaView all articles
Guarding Minds: A Narrative Review on How Antioxidants could shield Sensitive Patients from Antibiotic Neuropsychiatric Toxicity
Provisionally accepted
- University Psychiatric Clinic Basel, Basel, Switzerland
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Background: Antibiotics, indispensable in combating infectious diseases and extending life expectancy, are among the most commonly prescribed medications globally. However, neurotoxicity, encompassing neurological and psychiatric adverse effects, is an underrecognized phenomenon associated with all major classes of antibiotics. Certain antibiotics, such as fluoroquinolones, carry risks of permanent damage, including central and peripheral nervous system injury and mitochondrial dysfunction. Sensitive populations, such as the elderly and individuals with compromised organ function or genetic predispositions, are particularly vulnerable.Aims: To review evidence on the neurological and psychiatric side effects of antibiotics and evaluate potential neuroprotective strategies like N-acetylcysteine (NAC) and ketone bodies.Method: Narrative review of preclinical, clinical and epidemiologic studies.Results: Neurological and psychiatric side effects are rare, but they can be devastating NAC shows promise in preclinical studies for mitigating oxidative stress and cellular damage. Ketones, through ketogenic diets or exogenous supplementation, may provide neuroprotection via enhanced mitochondrial function and anti-oxidative and antiinflammatory effects.While initial findings are promising, further research is required to validate the clinical efficacy of these protective agents. Improved understanding of antibiotic neurotoxicity and potential mitigation strategies could lead to safer prescribing practices, particularly for vulnerable populations, balancing risk mitigation with the essential benefits of antibiotics.
Keywords: Antibiotic neuropsychiatric toxicity, neurological adverse effects, Psychiatric Side Effects, Mitochondrial dysfunction, Oxidative Stress, antioxidants (N-acetylcysteine -NAC), ketogenic diet and ketones, Neuroprotective strategies
Received: 16 Apr 2025; Accepted: 15 May 2025.
Copyright: © 2025 Lounici. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Astrid Lounici, University Psychiatric Clinic Basel, Basel, Switzerland
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