Britons who frequently take prescription antibiotics should be reminded of the risk of developing suicidal thoughts, health chiefs say.
The measure follows the death of a recently retired doctor, who took his own life just a week after starting ciprofloxacin.
Respected cardiologist Robert Stevenson, 63, had no prior history of depression or mental health problems.
Ciprofloxacin is one of the five Antibiotics officials have raised the alarm, following a coroner’s report into Mr Stevenson’s death.
They all fall within the fluoroquinolone family.
Five types of fluoroquinolone antibiotics may increase the risk of patients experiencing thoughts of self-harm and suicide after taking the drug, the UK medicines watchdog said
Warnings about possible ‘psychiatric reactions’ can already be found in leaflets in medicine boxes.
The Medicines and Healthcare products Regulatory Agency (MHRA) said healthcare professionals are ‘reminded to advise patients to be alert to these risks’.
Patients should also be advised to read the Patient Information Leaflets and ask them to seek medical advice if they experience similar symptoms according to the body.
Use should be discontinued at the ‘first sign’ of a serious adverse reaction.
The MHRA said: ‘If prescribing a fluoroquinolone, advise patients to be alert for any mood changes, distressing thoughts or feelings about suicide or harming themselves at any time during treatment.’
The watchdog’s advice to medics also said they should tell Britons to warn their loved ones about their prescription.
Patients may ‘not notice’ changes in mood and behavior themselves, ‘so it is very important to tell your friends and family that you are taking these medications’.
‘Others can spot changes and help you quickly identify any symptoms you need to talk to your doctor about,’ the MHRA said.
Depression and psychosis patients may see their symptoms worsen under treatment, the agency added.
Besides ciprofloxacin, the other antibiotics mentioned are delafloxacin, levofloxacin, moxifloxacin and ofloxacin. They are designed to fight serious bacterial infections.
According to the latest NHS data, almost 500,000 fluoroquinolone prescriptions were dispensed by GPs and other practitioners in England alone in 2022.
Mr Stevenson had not been informed of a “potential rare association” with suicidal behavior in patients taking the drug because it was not in line with medical guidelines, a hearing earlier this year heard.
The Prevention of Future Deaths Report, published in June and sent to the MHRA, said the cardiologist and GP at Huddersfield Royal Infirmary, West Yorks, had retired in May 2022.
At the time, he had been referred to a urology department for examination for possible prostate cancer, together with a private urologist.
To help with the inflammation of his prostate gland and to prepare him for a research biopsy, he was prescribed ciprofloxacin.
But just over a week later, Dr Stevenson left his house for his ‘regular walk’. According to the report, “he had not previously given any indications to his family that they were concerned about him.”
That afternoon, however, his wife received a Facebook message from him stating that he had left a note under the pillow of his bed.
Dr. Stevenson was later found dead in a nearby forest.
In the report, coroner Martin Fleming said that while it was unclear whether he suffered this side effect, it was still possible.
“I have heard evidence to suggest that the prescriber did not mention this side effect at the time he issued the prescription to Mr Stevenson because this was not in accordance with current advice,” Mr Fleming wrote.
‘I have also heard evidence suggesting that prescribers may not be fully aware of this rare side effect, and that patients suffering from depression may be more vulnerable to it.’
All Britons are urged to report any side effects from medicines they notice to the MHRA’s Yellow Card Scheme.
The watchdog claimed that it was not possible to indicate the period of risk or how often these potential side effects occur based on the available data.
It is thought that because fluoroquinolones act on mitochondria – powerhouses in cells responsible for releasing energy – the effects are felt throughout the body.
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