H. pylori Treated With Clarithromycin Linked To Transient Neuropsychiatric Events

MedicalResearch.com Interview with:
Dr Esther W Chan PhD
Assistant Professor
Research Lead, Centre for Safe Medication Practice and Research
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

MedicalResearch.com: What is the background for this study?

Dr. Chan: In the past decades, numerous case reports suggested that clarithromycin might induce neuropsychiatric events including psychotic manifestations and cognitive disturbances. Neuropsychiatric safety concerns are also listed for clarithromycin in British National Formulary in the United Kingdom and Physicians’ Desk Reference in the United States. Recent case reports also described neuropsychiatric cases relating to clarithromycin based H pylori therapy. However, the association remained unclear as there was no population-based observational study to examine the association. Therefore, we conducted a population-based observational study for investigating the neuropsychiatric safety of H pylori therapy containing clarithromycin.

MedicalResearch.com: What are the main findings?

Dr. Chan: We conducted a population-based observational study using self-controlled case series and nested case-control study designs to investigate the association between H pylori therapy containing clarithromycin and neuropsychiatric events. The result showed a 4-fold increased risk of neuropsychiatric events during current use of H pylori therapy containing clarithromycin. However, the risk did not persist after the end of H pyloritherapy.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Chan: Patients who are prescribed H pylori therapy containing clarithromycin should be monitored for the transient neuropsychiatric events so that preventable psychiatric interventions can be avoided.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Chan: Not only does H pylori therapy contain clarithromycin, but also other ingredients such as amoxicillin or metronidazole and proton pump inhibitors. Therefore, we could not entirely rule out the possible neuropsychiatric effects of other drugs in our study. It is important to conduct future studies concerning neuropsychiatric safety on these drugs as they are widely prescribed in clinical settings. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Wong AS, Wong IK, Chui CL, et al. Association Between Acute Neuropsychiatric Events and Helicobacter pylori Therapy Containing Clarithromycin.JAMA Intern Med. Published online May 02, 2016. doi:10.1001/jamainternmed.2016.1586.

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Last Updated on May 4, 2016 by Marie Benz MD FAAD