OBJECTIVES

Fluoroquinolone-associated neuropsychiatric disability is a serious adverse drug reaction described by a National Cancer Institute funded pharmacovigilance program in 2014 and an epidemiologist employed by the FDA in 2016. Suicide and attempted suicides are two of the most severe neuropsychiatric toxicities.The aim of the study is to investigate the impact of age on Cipro/levofloxacin associated suicides.

METHODS

The data collected by the Food and U.S. Drug Administration(FDA), were reported from 1998-2016. We categorized the age into 4 groups. There were 55 patients taken ciprofloxacin age between 12-84-year old.

RESULTS

The mean age was 47.34±15.3. Twenty-sixth (47%) were in 45-64-year-old group and eight of these individuals with completed suicides also had received Celexin, an antidepressant. Overall, 23 patients with suicide or suicide attempts had taken levofloxacin; their ages were 22-84-year olds. The mean age was 52.6±20.8 years. Only 30% reported taking concomitant drugs. Two thirds of the suicides had received concomitant corticosteroid and levofloxacin, all persons with suicides were under 60-year-old. Both groups reported Tinnitus, Depression, Insomnia and others before suicide but most completed suicides reported fewer symptoms prior to death. Additional year of age of patients with ciprofloxacin was associated with 1.1 times more likely odds of completing suicide (95%CI,1.041,1.182).

CONCLUSIONS

Suicide attempts and success were observed within all age categories. Older adults were more likely to have committed suicide. Although sample sizes are low, suicidal attempts and suicides are important concerns among adults and the elderly for patients taking Cipro/levofloxacin. Expanding the product label for levofloxacin, but not ciprofloxacin, is short-sighted.