Repeated Erythromycin/Codeine-induced psychotic mania

BACKGROUND: Mania is generally associated with bipolar disorder; however, it can be iatrogenic. For instance, antibiotics and corticosteroids can cause manic symptoms. CASE REPORT: Here, we present a case of a young man who had symptoms of psychotic mania after administration of erythromycin and acetaminophen with codeine on 2 separate occasions, with rapid resolution of each episode. CONCLUSIONS: Adverse events of psychotic mania have been rarely reported with erythromycin and acetaminophen with codeine, despite these being commonly prescribed medications. Clinicians should be aware that these drugs may be an iatrogenic cause of psychiatric disturbances and that these adverse events are more likely to occur during their concomitant use.