From the FDA Drug Label
Central Nervous System Disorders: Convulsions, increased intracranial pressure, and toxic psychosis have been reported in patients receiving quinolones, including ciprofloxacin Ciprofloxacin may also cause central nervous system (CNS) events including: dizziness, confusion, tremors, hallucinations, depression, and, rarely, suicidal thoughts or acts.
Yes, Cipro (ciprofloxacin) can cause altered mental status, as evidenced by reported CNS events including confusion, hallucinations, and depression 1.
From the Research
Ciprofloxacin (Cipro) can indeed cause altered mental status as a side effect, and patients with a history of neuropsychiatric disorders and those over 70 years old are at higher risk of developing these adverse reactions. This fluoroquinolone antibiotic has been associated with central nervous system effects including confusion, hallucinations, disorientation, agitation, nervousness, and even psychosis in some patients 2. The mechanism appears to be related to Cipro's ability to cross the blood-brain barrier and potentially interfere with GABA receptors in the brain, which are important inhibitory neurotransmitter receptors.
Key Points to Consider
- The overall incidence of neurological adverse drug reactions (ADRs) due to ciprofloxacin is 3.6% 2.
- No neurological ADRs developed in patients aged less than 70 years 2.
- A history of neuropsychiatric disorders is a significant risk factor for developing ciprofloxacin-induced neuro-psychiatric ADRs 2.
- If you experience any mental status changes while taking Cipro, you should contact your healthcare provider immediately as this could be a serious adverse effect requiring medication discontinuation.
Management and Prevention
- Alternative antibiotics may be prescribed depending on the infection being treated.
- These mental effects typically resolve after stopping the medication, though in rare cases symptoms may persist longer.
- It is essential to monitor patients closely for signs of altered mental status, especially those with a history of neuropsychiatric disorders or those over 70 years old, and to discontinue ciprofloxacin immediately if any adverse effects occur 2.