Microbial Dance: How infections swing the mood  


Mood swing is the cardinal clinical feature of bipolar disorder of the present or manic depression of the past. This common disorder of mood swing, has been recognized from the age of antiquity. Hippocrates, the father of medicine, has described the mania, that without it, bipolar disorder or manic depression could not be diagnosed, as a state of high energy and euphoria. He appreciated the importance of the brain to be the site of all these mood changes and not the heart: “Men ought to know that from the brain and from the brain only arrives our pleasures, joys, laughter and jests, as well as our sorrow, pains, grieves and tears…wherefore, I assert, the brain is the interpreter of the consciousness.” (1, 2)

 The differentiating fact between the unipolar disorder or depression and bipolar disorder or manic depression, known well in the ancient world, was buried in history until in mid-nineteen century when in 1854, the French psychiatrist, Falret, brought it back to recognition under the term “La folie circulaire”. (3) But it was not until Emil Kraeplin (4) in 1919 popularized the disorder under the term of “manic-depressive insanity” in his historical text-book, elaborating on all his predecessors including Karl Kahlbaum’s concept of “cyclothymia” (5)

 Clinically bipolar disorder or manic depression, is characterized by mood swings at different rates and severity, and on that basis is classified to classical or type I, with long cycles of severe elevation and depression of mood, of at least a few months each. Milder form of the disorder or mood swings has been classified as type II, with less severe depressive and high mood (called “hypomania”). Shorter cycles of these mood swings, form days to weeks are classified as rapid cycling and within day, as ultra cycling bipolar disorder or mood swings. The high mood state that could manifest as elation or agitation and aggression, is accompanied with elation in many mood and cortical functions, such as thought racing, pressured speech, self-esteem elevation, high physical and mental energy, shopping spree, risk taking behavior, hypersexuality, less need for sleep, etc. The depressive cycle is similar to unipolar or usual depression with an inversion of almost all the mood and mental states to the low side. It seems that the higher the mood elevation, the more severe the downfall of depression would be, such as the higher risk of suicide in bipolar depression than the unipolar or major depression (26-6% vs. 17.8% suicide attempts) (6).    

 The story of microbes of different kinds causing insanity or mental illness, including mood swings, manic depression of the past or bipolar disorder of the modern time, is not something new, but perhaps under-recognized. Julius Wagner-Jauregg (1857-1940) (7) an Austrian physician who won the noble prize in medicine for his discovery of malaria inoculation for the treatment of dementia paralytica or general paresis of insane (GPI) caused by neurosyphlilis, was one of the first who believed in such association. He thought and practiced induction of high fever (pyrotherapy) to cure psychoses including manic depression, initially by inoculation of tuberculin and later on plasmodium vivax, the microbe of malaria. (8)

 The first recorded association of infection with psychoses and probably manic depression or bipolar disorder, per PubMed search is an article by Muchnik in the Russian Psychiatric journal of “Zhurnal nevropatologii i psikhiatrii imeni Korsakova” in 1970. (9) Interestingly the journal has been named after the eminent Russian neuro-psychiatrist of 19th century, Sergie Korsakoff who was one of the frontiers of searching and demonstrating the organic origin of psychoses, leading him to discovery of Krosakoff Syndrome, a type of alcoholic psychosis due to thiamine deficiency. Muchnik in his prominent research over 12 years period, rare for the time and even now, studied the emergence of psychoses in 150 of patients in age range of 16-45 years old, “closely coincident in time with exacerbations of focal suppurative or rheumatic infections” He truly suggested that psychoses due to infections occur upon hereditary predispositions, although he wrongly called it of “allergic origin”. He also suggested “mental diseases diagnosed as periodic schizophrenia, atypical manic-depressive psychosis, organic brain lesion pursuing a periodic course, etc., are undoubtedly psychoses of infectious origin.”

 Soon after in the western society, Steinberg et al. (10) in the British Journal of Psychiatry, described a patient who in the course of a febrile illness during an influenza epidemic, “showed symptoms of an acute confusional state which then developed into a manic psychosis of prolonged duration.” This patient during the entire period of her psychiatric illness had unusually high levels of Influenza A antibody titer at the extreme range compared to other influenza patients, and moreover her titers remained abnormally high for an unusual period of time as compared to other influenza patients. These researchers based on this case, challenged the concept of `functional’ affective psychosis of the time.

 Krauthammer & Klerman in 1978 (11) in a review in the prominent journal of Archives of General Psychiatry, warned clinicians that many seemingly primary manias could in fact be secondary to other medical causes including infections: “mania occurs secondary to drugs, infection, neoplasm, epilepsy, and metabolic disturbances. These cases are best considered secondary manias. They suggest that mania–like, for example, hypertension–is a syndrome with multiple causes and that with further research many manic syndromes currently considered primary will be shifted into the secondary category. Furthermore, the concept of secondary mania casts doubt on any unitary or single-agent hypothesis of the etiology of mania and supports the notion of a continuum of psychopathologic syndromes. Clinicians are alerted to the existence of this syndrome and are urged to screen for it when conditions warrant.”

Case reports such as “a 45-year-old physician with bipolar disorder presented with an acute organic psychosis, fever, and hematologic and serologic findings of a primary Epstein-Barr virus infection.” (12) prompted the prominent British psychiatrist, Timothy Crow to cast doubt on the primary etiology of schizophrenia and bipolar disorder to be of viral or viral-genetic interaction. (13) This soon led to the seasonal birth hypothesis of schizophrenia and bipolar disorder. (e.g. 14) A very good example of the link between infection and bipolar disorder, could be seen in AIDS patients where cases of mania and bipolar disorder have been many times reported. (e.g.15-16) AIDS due to its immunodeficiency could lead to many infections in the subjects including CNS infections (e.g. meningitis, encephalopathy) with psychiatric manifestations, such as mania or mood swings.

Borna virus that is a neurotropic infectious agent with a predilection for neurons and astrocytes in the limbic system and cerebrum of infected hosts, have also been reported causing encephalitis with mood disorders manifestations, specially mood swings and bipolar disorder symptoms. Fu et al. (17) have reported Borna virus-specific antibodies in the sera of 4.5% of 138 affectively ill patients, with the highest titers in bipolar patients. A similar finding has also been reported by Amesterdam et al. (18) in 265 unipolar and bipolar patients with the same prevalence of 4.5% detection of antibody against Borna virus in the sera of their sample. Similar findings have been reported by others researchers. (e.g. 19-20)  

 Several other infections, e.g. Lyme disease (21), Epstein-Barr virus (22-23), skin and nail infections (24), maternal influenza in the first and second-trimester (e.g. 25-27), West Nile Virus infection (28), dengue infection (29), adeno-associated virus 2 and parvovirus B19 (30-1), toxoplasma gondii (32-6), cytomegalovirus (37-9) and inflammatory bowel inflammations and infections (40) have been reported in link with bipolar disorder. On the other side, while the above infecting agents could be causal in bipolar disorder, some infections, e.g. HIV and hepatitis-B &-C could cause secondary mania, precipitating mania or carry higher risks of these infections in Bipolar patients. (41-9) For example it has been reported treatment with interferon alpha2b in patients with hepatitis could trigger mania. (46), or combination therapy with interferon and citalopram (47), manic traits induction with interferon therapy in depressed hepatitis C subjects (48), or a cascade of psychiatric symptoms including mania in hepatitis infected patients going under interferon treatment. (49)

 The infectious agents could directly invade and infect the brain and stall its development in the fetuses of infected pregnant mothers (18, 19,30,33,35) or and could cause a cascade of immune reactions in the human subjects, leading to a central nervous functional disorder such as bipolar disorder. (25, 29-31, 50) These microbial immune activation, as I have detailed elsewhere in the case of other neurodevelopmental disorders such as schizophrenia and autistic spectrum disorders (51-2), seem to only harm the vulnerable developing brain of the fetus and not the developed adult brains, e.g. the maternal brains. (53) The footsteps of such disturbed immune system of the off springs have led many experts to interpret the neuro-developmental disorders as autoimmune conditions (e.g. 54).  For example, Severance et al. (40) have found seroactive markers for inflammatory bowel disease in reaction to food derived proteins such as wheat gluten and bovine milk caseins in adult bipolar disorder subjects. In another study Stich and colleagues (50) have reported increased polysepcific anti-bodies in the CSF (central spinal fluid) of bipolar patients against not one but several viral and parasitic infections, suggestive of ongoing chronic inflammatory conditions in the brains of these individuals. There are also evidences pointing to the long-term destructive impact of the microbial invasion to our genetic make-ups. Avramopoulos et al. (55) like some others in the genome-wide association studies have reported the maternal and fetal infections causing gene mutations by creating schizophrenia and bipolar-associated SNPs (single nucleotide polymorphism) in the HLA (Human Leukocyte Antigens) regions of chromosomes. This fact has even been proven on animal infection models in-vitro, by causing infections to the maternal mouse models to detect the inflammatory consequences in the off springs. Such experiments have shown long-term alterations in GSK3β signaling of brain dopaminergic pathway that are critically implicated in schizophrenia and bipolar disorder. (56)

 Moreover it seems that the impact of a remote infection in the mothers of inflicted off springs, is not only limited to causing neurodevelopmental disorders such as bipolar disorder, and life-long sufferings. But the enduring even low grade inflammation in the immune system of the individuals seem to cause premature cell senescence and aging by shortening the telomeres of immune cells, e.g. T-lymphocytes. (57) The proinflammatory biomarkers such as cytokines, e.g. TNF(Tumor Necrosis Factor)-alpha seem to be specifically related to the manic or hypomanic (elevated mood states) than the depressive mood states in bipolar disorder (55), making this disorder closer to a neurodevelopmental and infectious origin compared to unipolar depression that could be otherwise. Interestingly the therapeutic effect of Lithium as perhaps the most effective mood stabilizer in bipolar disorder has been shown to be related to its anti-inflammatory and potential anti-oxidative properties. Albayrak and colleagues (58) have proven this hypothetical effect of lithium in an animal experiment through the inhibiting pro-inflammatory cytokine effect of lithium and the generation of reactive oxygen species (ROS) after induction of sepsis in lab rats. Also some anti-psychotic medications that are effective in the treatment of bipolar disorder, specially the manic phase of the disease have shown to have anti-toxoplasmic effect. (36)      

 While mood stabilizers such as Lithium and anti-psychotics could have anti-inflammatory and anti-oxidant effects, first of all as it is well known, they cannot be preventive and curative, meaning that they cannot reverse the pathological process in bipolar disorder. The other interesting fact is that antibiotics not only have no efficacy in this disorder, but could have triggering effects! One wonders the reason if infection is considered in the pathophysiological mechanism of disease causation. As explained elsewhere in the case of schizophrenia (51), first of all the infecting machinery, acts long earlier on the fetus through gestational infestations, leaving only their impact and damages on the off springs years after, hence causing a neurodevelopmental disorder, interrupting the normal brain development, as in case of schizophrenia and ASD. (52, 59) As it was briefly explained above and detailed elsewhere in the case of other neurodevelopmental disorders (51-2), only the footsteps of the early gestational infections could be traced through the evidence of inflammation in the afflicted individuals, but none of infections or the infecting agents! That is why antibiotics are not only effective but could be triggering through dampening the immune system, precipitating or facilitating the disease processes.

Since 1963 there have been reports of linking antibiotics precipitating mania in susceptible individuals as early as age 3. (60-5) The case report of Kane and Taylor in 1963 of mania associated with the use of cocaine and I.N.H. (Isoniazid, used in the treatment of Tuberculosis), was the first such alarming sign. A review of the published and unpublished literature on the link between treatment with antibiotics and triggering mania in 2002 by Abouesh et al. (61) reported 21 total published cases, 6 caused by clarithromycin, 13 by isoniazid, and 1 case each by erythromycin and amoxicillin. The authors contacted WHO for unpublished cases, found 82 reports, 27.6% caused by clarithromycin, 14.4% by ciprofloxacin, 12% by ofloxacin , and Cotrimoxazole, metronidazole, and erythromycin altogether responsible for 15 reported manic episodes. Cases reported by the FDA showed clarithromycin and ciprofloxacin to be the most frequently associated with the development of mania. (61) Interestingly these authors elected to name this syndrome “antibiomania.” A recent search of the literature at the time of writing these lines, through Pubmed of the NIH (National Institute of health) in US resulted in 17 published cases only for Clarithromycin, 12 of them occurred after the review by Abouesh, including three cases alone in 2014, two in elderly and two in children, the extremes of life span where immunity is the most fragile.


Mania or hypomania which is the elevation of mood in a pathological manner, so steering away the individual out of touch with reality, even in the absence of psychosis, into an ecstatic state of mind, seems to have been initiated by the microbial world long before the person has even been born. The inflicted patient may be happy about such mood elevation and its consequences, thought racing, pressured speech, high energy, inflated self-esteem, acting flamboyantly, risk taking, substance abuse and hyper-sexuality. But such individuals are not aware that such fast and abnormal mood elevation, will result in a consequential mood downfall of severe depression that suicide could be eminent. It may take a long effort of the clinicians and the family of such individuals to help him or her to recognize that these mood swings are actually pathological, so the person finally after years of swaying around by the wind of incontrollable emotions, be convinced of having a disorder and stick to the treatment. But the available treatment is far from stabilizing these mood swings, lest curing the condition. The reason is perhaps in the lack of our full knowledge and appreciation of the pathophysiology of the bipolar disorder and other neurodevelopmental conditions, caused long time before the onset of these disorders by microbial invasions. In fact the world should know that these are the microbes, seemingly of different kinds, behind the curtain, make the inflicted persons to dance like puppets!

Dr.Mostafa Showraki, MD, FRCPC                                                               Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”


  1. Goodwin FK, Jamison KR. Manic-Depressive Illness. Oxford University Press: Oxford. 1990.
  2. Jakson S. Melancholia and depression: from Hippocratic times to modern times. Yale University Press. 1986.
  3. Falret J. Memoire sur la folie circulaire. Bulletin de la Academie imperiald de medicine. 1854.
  4. Kraeplin E. Manic–depressive Insanity and Paranoia. (trans.R.M.Barclay). Livingstone, Edinburgh.
  5. Kahlbaum K. Uber cyclishes irresein. Der Irrenfreund. 1882.
  6. Bottlender R, Jäger M, Strauss A, Möller HJ. Suicidality in bipolar compared to unipolar depressed inpatients. Eur Arch Psychiatry Clin Neurosci. 2000;250(5):257-61.
  7. Allerberger, F (1997). “Julius Wagner-Jauregg (1857-1940)”. Journal of Neurology, Neurosurgery & Psychiatry 62 (3): 221–221.
  8. Gretchen Vogel (8 November 2013). “Malaria as a Lifesaving Therapy”. Science 342 (6159): 686.
  9. Muchnik, L. S. Materials on the study of psychoses of infectious-allergic origin. Zhurnal Nevropatologii i Psikhiatrii, Vol 70(4), Apr 1970, 570-576.
  10. Steinberg, D., Hirsch S. R, Marston N S. D., Reynolds K., Sutton R. N. P. Influenza Infection Causing Manic Psychosis. The British Journal of Psychiatry May 1972, 120 (558) 531-535.
  11. Krauthammer C, Klerman GL. Secondary mania: manic syndromes associated with antecedent physical illness or drugs. Arch Gen Psychiatry. 1978 Nov;35(11):1333-9.
  12. Klein RF, Betts R, Horn R, Sullivan JL. Acute psychosis in a 45-year-old man with bipolar disorder and primary Epstein-Barr virus infection: a case report. Gen Hosp Psychiatry. 1984 Jan;6(1):13-5.
  13. Crow TJ. A re-evaluation of the viral hypothesis: is psychosis the result of retroviral integration at a site close to the cerebral dominance gene? Br J Psychiatry. 1984 Sep;145:243-53.
  14. Boyd JH, Pulver AE, Stewart W. Season of birth: schizophrenia and bipolar disorder. Schizophr Bull. 1986;12(2):173-86.
  15. Johannessen DJ, Wilson LG. Mania with cryptococcal meningitis in two AIDS patients. J Clin Psychiatry. 1988 May;49(5):200-1.
  16. Schmidt U, Miller D. Two cases of hypomania in AIDS. Br J Psychiatry. 1988 Jun;152:839-42.
  17. Fu ZF, Amsterdam JD, Kao M, Shankar V, Koprowski H, Dietzschold B. Detection of Borna disease virus-reactive antibodies from patients with affective disorders by western immunoblot technique. J Affect Disord. 1993 Jan;27(1):61-8.
  18. Amsterdam JD, Winokur A, Dyson W, Herzog S, Gonzalez F, Rott R, Koprowski H. Borna disease virus. A possible etiologic factor in human affective disorders? Arch Gen Psychiatry. 1985 Nov; 42(11):1093-6.
  19. Rott R, Herzog S, Fleischer B, Winokur A, Amsterdam J, Dyson W, Koprowski H. Detection of serum antibodies to Borna disease virus in patients with psychiatric disorders. Science. 1985 May 10; 228(4700):755-6.
  20. Bode L, Reckwald P, Severus WE, Stoyloff R, Ferszt R, Dietrich DE, Ludwig H.Borna disease virus-specific circulating immune complexes, antigenemia, and free antibodies–the key marker triplet determining infection and prevailing in severe mood disorders. Mol Psychiatry. 2001 Jul; 6(4):481-91.
  21. Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness. Am J Psychiatry. 1994 Nov;151(11):1571-83.
  22. Pavuluri MN, Smith M. A neuroimmune hypothesis for the aetiopathology of viral illness and manic depression: a case report of an adolescent. J Affect Disord. 1996 Jun 20;39(1):7-11.
  23. Klein RF, Betts R, Horn R, Sullivan JL. Acute psychosis in a 45-year-old man with bipolar disorder and primary Epstein-Barr virus infection: a case report. Gen Hosp Psychiatry. 1984 Jan; 6(1):13-5.
  24. Arrese JE, Piérard-Franchimont C, Piérard GE. Onychomycosis and keratomycosis caused by Alternaria sp. A bipolar opportunistic infection in a wood-pulp worker on chronic steroid therapy. Am J Dermatopathol. 1996 Dec;18(6):611-3.
  25. Stöber G, Kocher I, Franzek E, Beckmann H. First-trimester maternal gestational infection and cycloid psychosis. Acta Psychiatr Scand. 1997 Nov;96(5):319-24.
  26. Machón RA, Mednick SA, Huttunen MO. Adult major affective disorder after prenatal exposure to an influenza epidemic. Arch Gen Psychiatry. 1997 Apr;54(4):322-8.
  1. Parboosing R, Bao Y, Shen L, Schaefer CA, Brown AS. Gestational influenza and bipolar disorder in adult offspring. JAMA Psychiatry. 2013 Jul;70(7):677-85.
  2. Ohry A, Karpin H, Yoeli D, Lazari A, Lerman Y. West Nile Virus Myelitis. Spinal Cord. 2001 Dec;39(12):662-3.
  3. Mendhekar DN, Aggarwal P, Aggarwal A. Classical mania associated with dengue infection. Indian J Med Sci. 2006 Mar;60(3):115-6.
  1. Hobbs JA. Detection of adeno-associated virus 2 and parvovirus B19 in the human dorsolateral prefrontal cortex. Neurovirol. 2006 Jun;12(3):190-9.
  2. Mortensen PB, Pedersen CB, McGrath JJ, Hougaard DM, Nørgaard-Petersen B, Mors O, Børglum AD, Yolken RH. Neonatal antibodies to infectious agents and risk of bipolar disorder: a population-based case-control study. Bipolar Disord. 2011 Nov-Dec;13(7-8):624-9.
  3. Pearce BD, Kruszon-Moran D, Jones JL. The relationship between Toxoplasma gondii infection and mood disorders in the third National Health and Nutrition Survey. Biol Psychiatry. 2012 Aug 15;72(4):290-5.
  4. Severance EG, Kannan G, Gressitt KL, Xiao J, Alaedini A, Pletnikov MV, Yolken RH. Anti-gluten immune response following Toxoplasma gondii infection in mice. PLoS One. 2012;7(11):e50991.
  5. Hamdani N, Daban-Huard C, Lajnef M, Richard JR, Delavest M, Godin O, Le Guen E, Vederine FE, Lépine JP, Jamain S, Houenou J, Le Corvoisier P, Aoki M, Moins-Teisserenc H, Charron D, Krishnamoorthy R, Yolken R, Dickerson F, Tamouza R, Leboyer M. Relationship between Toxoplasma gondii infection and bipolar disorder in a French sample. J Affect Disord. 2013 Jun;148(2-3):444-8.
  6. Fond G, Macgregor A, Tamouza R, Hamdani N, Meary A, Leboyer M, Dubremetz JF. Comparative analysis of anti-toxoplasmic activity of antipsychotic drugs and valproate. Eur Arch Psychiatry Clin Neurosci. 2014 Mar;264(2):179-83.
  7. Dickerson F, Stallings C, Origoni A, Vaughan C, Katsafanas E, Khushalani S, Yolken R. Antibodies to Toxoplasma gondii in individuals with mania. Bipolar Disord. 2014 Mar;16(2):129-36.
  8. Marangoni C, Hernandez M, Faedda GL. The role of environmental exposures as risk factors for bipolar disorder: A systematic review of longitudinal studies. J Affect Disord. 2016 Jan 1;193:165-174.
  9. Rizzo LB, Do Prado CH, Grassi-Oliveira R, Wieck A, Correa BL, Teixeira AL, Bauer ME. Immunosenescence is associated with human cytomegalovirus and shortened telomeres in type I bipolar disorder. Bipolar Disord. 2013 Dec;15(8):832-8.
  10. Prossin AR, Yolken RH, Kamali M, Heitzeg MM, Kaplow JB, Coryell WH, McInnis MG. Cytomegalovirus Antibody Elevation in Bipolar Disorder: Relation to Elevated Mood States. Neural Plast. 2015;2015:939780.
  11. Severance EG, Gressitt KL, Yang S, Stallings CR, Origoni AE, Vaughan C, Khushalani S, Alaedini A, Dickerson FB, Yolken RH. Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder. Bipolar Disord. 2014 May;16(3):230-40.
  12. Barbosa IG, Vale TC, de Macedo DL, Gomez RS, Teixeira AL. Neurosyphilis presenting as mania. Bipolar Disord. 2012 May;14(3):309-12.
  13. Ellen SR, Judd FK, Mijch AM, Cockram A. Secondary mania in patients with HIV infection. Aust N Z J Psychiatry. 1999 Jun;33(3):353-60.
  14. Baillargeon JG, Paar DP, Wu H, Giordano TP, Murray O, Raimer BG, Avery EN, Diamond PM, Pulvino JS. Psychiatric disorders, HIV infection and HIV/hepatitis co-infection in the correctional setting. AIDS Care. 2008 Jan;20(1):124-9.
  15. Nakimuli-Mpungu E, Musisi S, Mpungu SK, Katabira E. Primary mania versus HIV-related secondary mania in Uganda. Am J Psychiatry. 2006 Aug;163(8):1349-54.
  16. de Sousa Gurgel W, da Silva Carneiro AH, Barreto Rebouças D, Negreiros de Matos KJ, do Menino Jesus Silva Leitão T, de Matos e Souza FG; Affective Disorders Study Group (GETA). Prevalence of bipolar disorder in a HIV-infected outpatient population. AIDS Care. 2013;25(12):1499-503.
  17. Basanth KK, Jacob R, Jacob KS. Mania associated with interferon alpha2b treatment. J Postgrad Med. 2006 Jul-Sep;52(3):207-9.
  18. Wu PL, Liao KF, Peng CY, Pariante CM, Su KP. Manic episode associated with citalopram therapy for interferon-induced depression in a patient with chronic hepatitis C infection. Gen Hosp Psychiatry. 2007 Jul-Aug;29(4):374-6.
  19. Lim C, Olson J, Zaman A, Phelps J, Ingram KD. Prevalence and impact of manic traits in depressed patients initiating interferon therapy for chronic hepatitis C infection. Clin Gastroenterol. 2010 Aug;44(7):e141-6.
  20. Giunta B, Somboonwit C, Nikolic WV, Rrapo E, Tan J, Shapshak P, Fernandez F. Crit Rev Neurobiol. 2007;19(2-3):79-118. Psychiatric implications of hepatitis-C infection. Crit Rev Neurobiol. 2007;19(2-3):79-118.
  21. Stich O, Andres TA, Gross CM, Gerber SI, Rauer S, Langosch JM. An observational study of inflammation in the central nervous system in patients with bipolar disorder. Bipolar Disord. 2015 May;17(3):291-302.
  22. Showraki, M. From infection to Schizophrenia: A road less revealed. Medicinerevisited.com.2015.
  23. Showraki, M.Towards prevention of Autism and other neurodevelopmental disorders. Medicinerevisited.com.2015.
  24. Carmichael AJ, Paul CJ. Idiosyncratic dapsone induced manic depression. BMJ. 1989 Jun 3;298(6686):1524.
  25. Chaturvedi SK, Upadhyaya M. Secondary mania in a patient receiving isonicotinic acid hydrazide and pyridoxine: case report. an J Psychiatry. 1988 Oct;33(7):675-6.
  26. Avramopoulos D, Pearce BD, McGrath J, Wolyniec P, Wang R, Eckart N, Hatzimanolis A, Goes FS, Nestadt G, Mulle J, Coneely K, Hopkins M, Ruczinski I, Yolken R, Pulver AE. Infection and inflammation in schizophrenia and bipolar disorder: a genome wide study for interactions with genetic variation. PLoS One. 2015 Mar 17;10(3):e0116696.
  27. Willi R, Harmeier A, Giovanoli S, Meyer U. Altered GSK3β signaling in an infection-based mouse model of developmental neuropsychiatric disease. Neuropharmacology. 2013 Oct;73:56-65.
  28. Fond G, Boyer L, Gaman A, Laouamri H, Attiba D, Richard JR,Delavest M, Houenou J, Le Corvoisier P, Charron D, Krishnamoorthy R, Oliveira J, Tamouza R, Yolken R, Dickerson F, Leboyer M, Hamdani N. Treatment with anti-toxoplasmic activity (TATA) for toxoplasma positive patients with bipolar disorders or schizophrenia: a cross-sectional study. J Psychiatr Res. 2015 Apr;63:58-64.
  29. Albayrak A, Halici Z, Polat B, Karakus E, Cadirci E, Bayir Y, Kunak S, Karcioglu SS, Yigit S, Unal D, Atamanalp SS. Protective effects of lithium: a new look at an old drug with potential antioxidative and anti-inflammatory effects in an animal model of sepsis. Int Immunopharmacol. 2013 May;16(1):35-40.
  30. Cordeiro CN, Tsimis M, Burd I. Infections and Brain Development. Obstet Gynecol Surv. 2015 Oct;70(10):644-55.
  31. Kane , Taylor TW. Mania associated with the use of I.N.H. and cocaine.Am J Psychiatry. 1963 May;119:1098-9.
  32. Abouesh A, Stone C, Hobbs WR. Antimicrobial-induced mania (antibiomania): a review of spontaneous reports. J Clin Psychopharmacol. 2002 Feb;22(1):71-81.
  33. Nightingale SD, Koster FT, Mertz GJ, Loss SD. Mania due to clarithromycin therapy in a patient who was not infected with human immunodeficiency virus. Clin Infect Dis. 1995 Jun;20(6):1563-4.
  34. Abouesh A, Hobbs WR.Clarithromycin-induced mania. Am J Psychiatry. 1998 Nov;155(11):1626.
  35. Karstaedt AS, Kooverjee S, Singh L, Jeenah Y, Jonsson G. Antiretroviral Therapy Outcomes in Patients with Severe Mental Illness. J Int Assoc Provid AIDS Care. 2015 Sep-Oct;14(5):428-33.
  36. Bhalerao S, Talsky A, Hansen K, Kingstone E, Schroeder B, Karim Z, Fung I. Ciprofloxacin-induced manic episode. Psychosomatics. 2006 Nov-Dec;47(6):539-40.


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