Toxic Catatonia Secondary to Azithromycin

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Sir: Several publications report psychiatric symptoms induced by macrolide antibiotics. Clarithromycin and erythromycin used in combination with other treatments, or even in monotherapy, have been reported to produce acute psychoses,^1-6 manic episodes,^7-12 and depression.¹³ To our knowledge, this is the first report of an association between azithromycin, another macrolide antibiotic, and the initiation of acute psychotic depression with catatonic symptoms.’ ‹’ ‹