next »

[treehugger1]

Has anyone here ever had cognitive side-effects from high-powered antibiotics?

I swore I'd never take Cipro and Flagyl again. But I am (they's apparently the most effective antibiotics for diverticulitis available to outpatients) and am having all the wierd psychiatric, emotion, cognitive symptoms I had when I took the combo last time -- brain fog, bouts of intense anger for no particular reason, and depression -- or at least the feeling of total "blah"ness. (And this besides the indigestion, dry mouth, tinnatus, tingling hands + feet, fatigue and .... I'm probably forgetting something, but you get the picture)

I am aware enough to know I *need* to work, that I must work (have looming deadline), and yet I'm sitting in front of my computer fighting off paranoia and struggling to put two ideas together. I am writing, but to say that it's not flowing is an understatement. One lousy half page of crapola after 4+ hours of work.

Only five more days ....

So, has any one else had this kind of problem with Cipro/Flagyl or any other high-powered antibiotic? Did you just keep slogging through? Give up and rest for a while? I'm trying to figure out it this is a "just tough it hard and try harder" situation or "you really are not well, take it easy" situation. Otherwise, can one overcome these kind of effects through an effort of the will? Any tricks? Or just try harder?

[lolar2]

I've never taken either of those when I wasn't also taking something even worse, like prednisone or narcotics or something. However, I would swear that penicillin gives me panic attacks.

As to whether to give up and rest, I normally recommend resting when in doubt, or else you might end up getting sick with something else and having to take even worse drugs, and then your productivity will be really screwed. That's just based on my own experience, of course.

[chaosbydesign]

Depression is a known side effect of metronidazole (Flagyl) and ciprofloxacin has been shown to be anxiogenic so you are definitely not alone in having these symptoms. I believe doxycyline is also suitable for the treatment of diverticulitis, so if it gets really bad you might be able to request a different combination of antibiotics. Side effects of doxycycline can be quite severe though, in terms of nausea and sickness - if you've ever had to take antimalaria tablets, you'll know what I mean by this, as doxycycline is a pretty common antimalarial drug.

Have a look for a paper by Ananth et al. if you want a little bit more background on psychological effects of certain medications (I'd look it out for you and link it but I can't seem to get my computer to cooperate with pubmed tonight - sounds like a student excuse for bad referencing doesn't it!)

I don't really have much advice for how to deal with the side effects as I've never experienced it myself, but if you're feeling anxious and depressed, it might help to rest a bit. Trying to work when you feel like this is probably going to exacerbate the symptoms you have already, especially if you are already getting frustrated. Maybe try working in small chunks, say ten to twenty minutes at a time, and have a quiet break in between.

I hope you feel better soon.

[spork]

Uhhh, if you are having tingling in the extremities, STOP taking the Flagyl and tell your physician.  Peripheral neuropathy can become permanent.

[lolar2]

Uhhh, if you are having tingling in the extremities, STOP taking the Flagyl and tell your physician.  Peripheral neuropathy can become permanent.

Ooh, yes, good catch! My eyes skipped right over that part.

[biomancer]

Uhhh, if you are having tingling in the extremities, STOP taking the Flagyl and tell your physician.  Peripheral neuropathy can become permanent.

Ooh, yes, good catch! My eyes skipped right over that part.

Yes - chime on this!!  And that doxy might be a safer route for you, provided you're not allergic to tetracycline (and tet allergies are really rare so that's unlikely).

Cipro-type drugs knock the stuffing out of me.  I was on moxifloxacin a few years back and wound up losing 15 pounds over two weeks because I was too nauseous to eat.

Seems to me that it's past time to call the physician for a change of medication.  It's no help if the meds are making you sicker, and it's really no help if you end up with permanent problems.  Get a note on your medical records showing that you react badly to Flagyl.

[treehugger1]

Uhhh, if you are having tingling in the extremities, STOP taking the Flagyl and tell your physician.  Peripheral neuropathy can become permanent.

I'm not *too* worried about this particular symptom since:

1) the tingling is really quite mild
2) it already comes and goes even as I take the medication, so it will probably go aware when I finish
3) I've already had IV Flagyl for a few days, so the worst is (hopefully) over.

Now, if the cognitive symptoms were to become permanant that would be something else.

Last time I had Cipro/Flagyl (a few years ago) I did indeed call my MD and stop it early, but then wound up having an almost immediate recurrence of the diverticulitis (one week later). I suppose I'd rather not fool around with the antibiotics than risk having another relapse. (Each relapse brings me closer to another abdominal surgery. And I really, really do not want that.)

[spork]

Uhhh, if you are having tingling in the extremities, STOP taking the Flagyl and tell your physician.  Peripheral neuropathy can become permanent.

I'm not *too* worried about this particular symptom since:

1) the tingling is really quite mild
2) it already comes and goes even as I take the medication, so it will probably go aware when I finish
3) I've already had IV Flagyl for a few days, so the worst is (hopefully) over.

Now, if the cognitive symptoms were to become permanant that would be something else.

Last time I had Cipro/Flagyl (a few years ago) I did indeed call my MD and stop it early, but then wound up having an almost immediate recurrence of the diverticulitis (one week later). I suppose I'd rather not fool around with the antibiotics than risk having another relapse. (Each relapse brings me closer to another abdominal surgery. And I really, really do not want that.)

Peripheral neuropathy is nothing to fool around with.  There are other antibiotics that kill anaerobic bacteria.

[treehugger1]

There are other antibiotics that kill anaerobic bacteria.

Such as ???

Seriously, I just called my pharmacist and he can't think of anything equivalent. Doxycyline is the equivalent of Cipro apparently, not Flagyl.

The other symptoms are getting better, but the tingling *is* getting a bit worse. Plus, I have a stiff neck.
 (Hopefully, this isn't all a matter of suggestion.)

I think I'm going to call the hospital and get in touch with the MD who originally prescribed it.

[oldfullprof]

I've expected to have to take Flagyl a few times, too.  I feel horrible on oral Flagyl.  Then have been told that a single antibiotic shot could be given instead.  The last one I had even contained a Lidocain admixture, so there was no pain.

[chaosbydesign]

There are other antibiotics that kill anaerobic bacteria.

Such as ???

Seriously, I just called my pharmacist and he can't think of anything equivalent. Doxycyline is the equivalent of Cipro apparently, not Flagyl.

The other symptoms are getting better, but the tingling *is* getting a bit worse. Plus, I have a stiff neck.
 (Hopefully, this isn't all a matter of suggestion.)

I think I'm going to call the hospital and get in touch with the MD who originally prescribed it.

Doxycyline is a tetracycline. Ciprofloxacin is a flouroquinoline.

Cephalexin (a cephalosporin) is an alternative.

Do NOT continue with the antibiotics you are on if you have symptoms of neuropathy.

[treehugger1]

chaos, spork + others,

Yes, I am now sufficiently freaked out. I am stopping the Flagyl. (I took a look at the prescription information and, sure enough, it does say: "CONTACT YOUR DOCTOR IMMEDIATELy if you experience ... tingling ... of the arms, hands, legs or feet ...")

But I am still doing research on possible alternatives.

chaos,

What I meant to say was that Doxycycline would not(???) be a replacement for Flagyl, not that it was *exactly* the same as Cipro. Sorry....

Do Doxycyline and Cephalexin target anaerobic bacteria as I believe Flagyl does?

According to this medical reference site , it seems like there are not many other choices for outpatients. I've already tried Augmentin and it doesn't work for me. The other ones all seem to be IV-administered.

BTW, I've tried getting in touch with various medical professionals -- pharmacist, PCP, nurse-line, hospital and nobody wants to give me an answer ... at least on a Saturday night. Maybe I should just chill.

[chaosbydesign]

chaos,

What I meant to say was that Doxycycline would not(???) be a replacement for Flagyl, not that it was *exactly* the same as Cipro. Sorry....

Do Doxycyline and Cephalexin target anaerobic bacteria as I believe Flagyl

They are efficient against anaerobic bacteria, yes, but they do not act in the same way as nitroimidazole antimicrobials do (which is what Flagyl is). Nitroimidazole antibiotics such as metronidazole effectively mutates bacterial DNA, whereas cephalexin is a beta-lactam antibiotic, which in simple terms means that it interferes with the ability of the bacterial to produce a structurally stable cell wall by triggering the action of an enzyme which breaks down one of the key components of the cell wall.

I know of a few other nitroimidazole antimicrobials, but a quick pubmed search indicates that they are not used for treatment of bacterial infections but protozoan infections.

I can't give you any medical advice as I'm a microbiologist, not a doctor. I suggest you make an appointment with your doctor ASAP and refuse to leave until they offer you alternative treatment. If you have to go inpatient for a few days to get that treatment, that is surely better than permanent neuropathy?

Do you know for sure that you have a bacterial infection? And if you do, do you know what that infection is?

[treehugger1]

Do you know for sure that you have a bacterial infection? And if you do, do you know what that infection is?

Well, I am sure that I *had* one just a few days ago. I am feeling fine now, but was attempting to take the full course of antibiotics as prescribed. I had an attack of severe diverticulitis (confirmed by CT-scan) and wound up in the hospital for 4 days (late Fri evening --> Tuesday noon). As an inpatient, I had Zosyn-IV and Flagyl-IV.

Thanks, for all the information, BTW. This is one reason why I love these fora.

[chaosbydesign]

Do you know for sure that you have a bacterial infection? And if you do, do you know what that infection is?

Well, I am sure that I *had* one just a few days ago.

This is why I was asking if you knew what it was you had. If you knew what the infection was, it would be easier for me to advise you based on what I know about how different bacteria infect, their 'incubation' times in the body etc.

If you want any more in-depth information, just ask - I have hundreds of scientific papers stored on my computer on antibiotics.