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Review
. 2025 Oct;33(5):797-799.
doi: 10.1177/10398562251370946. Epub 2025 Aug 23.

Antibiomania: An update

Gordon Parker  1 , Nicole Russo  1
Affiliations
Review

Antibiomania: An update

Gordon Parker et al. Australas Psychiatry. 2025 Oct.

Abstract

BackgroundAntibiomania, whereby an antibiotic induces a manic/hypomanic episode in those with or without a pre-existing bipolar condition, is a little-known phenomenon, diagnostically elusive, may be more prevalent than recognised and thus warrants the current overview.MethodRepresentative studies and clinical observations are noted.ResultsSeveral mechanistic issues are considered but with a weighting to the antibiotic causing gut dysbiosis and so activating gut-brain axis pathways that may induce manic/hypomanic episodes.ConclusionFuture studies should seek to determine the prevalence of antibiomania and whether differing antibiotics effect differential risks, while clinicians identifying such a potential linkage in a patient who has developed a first episode or recurrence of a manic/hypomanic episode should consider nuanced pre-emptive and management strategies in such instances.

Keywords: antibiotics; bipolar disorder; gut microbiome; mania.

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Conflict of interest statement

DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

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