What is fluoroquinolone toxicity?
Fluoroquinolone toxicity is created from taking any of the fluoroquinolone antibiotics. These are mainly Ciprofloxacin, Levaquin and Avelox. Toxicity from fluoroquinolones happens more than you think. When you take this class of drugs it creates mitochondrial dysfunction, central and autonomic nervous system dysfunction and psychiatric side effects. This powerful class of antibiotics, which has a black box warning, can pass the blood brain barrier (BBB) and permeate almost every tissue in your body. This causes cellular stress and ultimately downstream side effects to many systems in the body. If you have been affected by this class of drug.
How do fluoroquinolones cause depression, and anxiety?
Fluoroquinolones are among the most frequently reported causes of antibiotic-induced neuropsychiatric reactions. Based on a recent study, fluoroquinolones may be more commonly associated with delirium and psychosis than previously thought.9 Like macrolides, it is suspected that GABA-A antagonism causes proconvulsant activity, leading to adverse CNS effects. Additionally, fluoroquinolones have been reported to affect N-methyl-d-aspartate (NMDA) receptors in vitro, but further studies are needed to fully elucidate its mechanism.
The most common neuropsychiatric-related adverse effects from fluoroquinolones are excitatory effects, including insomnia, dizziness, headache, nervousness, and restlessness, which usually resolve upon discontinuation. Fluoroquinolone antibiotics can also cause more serious reactions. They have a black-box warning for potentially disabling and irreversible adverse effects including CNS events.
Seizures and status epilepticus can occur due to GABA-A inhibition. Therefore, fluoroquinolones should be used with caution in patients with a history of epilepsy. Encephalopathy, antibiomania, delirium, hallucinations, and acute psychosis are among the other neurotoxic manifestations associated with fluoroquinolones.
“Jill Cobb blames one of the most widely prescribed antibiotics in the country for destroying her physically. She suffers from pain so severe in her hip and shoulders she can barely walk.
She describes the mental anguish triggered by insomnia and anxiety as devastating as the pain. Cobb says the psychological side effects struck within days after being prescribed Levaquin.”
What Is GABA & Fluoruoquinolone Depressions Have In Common
Fluoroquinolone toxicity starts to chemically disrupt the way your body handles Gamma-aminobutyric acid (GABA) which is a neurotransmitter, a chemical messenger in your brain. It slows down your brain by blocking specific signals in your central nervous system (your brain and spinal cord).
GABA is known for producing a calming effect, that is why I usually work on this first with my clients. GABA is thought to play a major role in controlling nerve cell hyperactivity associated with anxiety, stress and fear. Fluoroquinolones antagonize (aggravate) this receptor leaving it unable to “calm” your nervous system. Say hello to sleepless nights, breathing issues, and anxiety attacks.
There are two types of GABA receptors on nerve cell which are called GABA-A and GABA-B. Fluoruoquinolones alter the GABA-A receptors. Although they work in different ways, when GABA binds to these receptors the result is that they decrease the responsiveness of the nerve cell. This means that as an inhibitory neurotransmitter, GABA lessens the ability of a nerve cell to receive, create or send chemical messages to other nerve cells. So Fluoroquinolones, through their mechanisms of action leave your GABA-A receptor altered for some time.
OMG GLUTAMATE IS YOUR ENEMY!
I dont know how many times I have had someone reach out to me and tell me their neurological symptoms got worse. Do you know the first question I ask them? Did you take glutamate or glutamine derivatives? The answer is almost always yes. So that soy sauce you just ate, MSG AKA Glutamine. Through multiple enzymes in your body which are now not working so well your body is able to handle glutamine but after FQ exposure this is your new kroptonite.
I like to say that GABA helps anti-antagonize the receptors and glutamine now antagonizes them so much more after fluoroquinolone toxicity. So please read supplement labels, food labels and no soy sauce please!
Is the Fluoroquinolone Depression Controllable?
I see so many “floxies” on Benzodiazepines (benzos) and SSRI medications to control the emotions, insomnia and other psychiatric conditions. However that does not fix the root problem here. The reason why Benzodiazepines work so well is because when a fluoroquinolone binds to a GABA receptor, the result is the polar opposite of the effect of CNS depressants like benzodiazepines. Fluoroquinolones prevent the binding of GABA and can displace other molecules bound to the receptor. So it is like fluoroquinolones turn off the faucet and ‘benzos” turn it off. That is all well and good but remember all medications have side effects and bezos have so many!
There is a natural way to alter the state of the of the GABA system and it really just takes a bit of time, consistency and hope. Your system will bounce back without benzos or SSRI medications. I have seen this happen with many of my clients, others in the community and friends online. So what about SSRI medications are those issues too?
Turn that frown upside down, the SSRI issue.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants, I know so many who are on them. They can ease symptoms of moderate to severe depression, are relatively safe and typically cause fewer side effects than other types of antidepressants do.
SSRIs treat depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain nerve cells (neurons).
SSRIs block the reabsorption (reuptake) of serotonin into neurons. This makes more serotonin available to improve transmission of messages between neurons. SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters.
I do understand the need for these drugs and I am certainly not telling you to take or not take a medication. However I feel you can help your serotonin levels naturally with herbs and other nutracueticals. I personally was prescribed Lexapro, of which I did not take because I use St. Johns Wort, a natural herb most anti-depressants are derived from. I will talk to you more in depth on this topic later.
Fluroquinolones in most cases damage the microbiome. The microbiome or your “gut” is where your neurotransmitters are made. Did you know that 95% of the serotonin in the body is located in the gut? Neurotransmitters are serotonin, Norepinephrine (NE), epinephrine (E), dopamine (DA) and these regulate your mood.
Here are some of the SSRI on the market
Paroxetine (Paxil, Pexeva)
Did you know that some of these drugs have fluoride in them? The fluoride in these drugs can cause a relapse in your symptoms from FQ toxicity. To check all drugs with added fluoride please check out this link here. I have stayed away from any drug with added fluoride due to the blood brain barrier issues and hope that you will understand the importance of what these drugs can do to your body.
So How Can You Help The GABA Issue?
I like to start from a place of using natural methods to coach my body back to homeostasis. I have used this method to help my GABA-A receptor come back online. This method has worked well for all of my coaching clients too. I want you to know that this advice is based on experiential knowledge and also based on research which you can find in the references below.
First I start with removing all glutamine and or glutamate derivatives from the diet. This will help the GABA-A receptor calm down and not antagonize it. In addition to removal I also think that detoxing from the drug should be of utmost importance directly after verifying toxicity. This will help your body balance from the fluoride in the drug and its affects on the body.
So we know that benzos help anti-antagonize the GABA receptors but did you know that you can also do that naturally? GABA is the main inhibitory neurotransmitter preventing over-stimulation of neurons. An abnormal GABA decrease can produce mental illness and symptoms such as anxiety, depression, insomnia, convulsions, and epilepsy. So adding supplemental GABA can decrease the antagonizing and binding effects from the fluoroquinolone. I will post a link below to the best form of this supplement which I have seen work so well.
Other Helpful Ways To Combat Fluroquinolone Depression And Anxiety
Kava (Piper methysticum) is a plant traditionally used by people from the South Pacific islands. Kava’s effect on GABA is complex because the plant contains 6 psychoactive compounds. One of the major kava psychoactive compounds is kavain, and it acts by stimulating GABAA receptors as a positive allosteric modulator 
Kava is usually prepared as a drink with the powder of its root. The recommended method for drinking kava is using premium kava prepared with the traditional water extract method .
In human studies (141, 20, and 101 volunteers), kava improved the symptoms of anxiety, insomnia, depression, sleep and agitation. Kava has become a new herbal remedy as a potenet alternative to benzodiazepines. See the link below for the best form of Kava.
2. Magnolia Bark
Magnolia officinalis, also known as magnolia bark, has been used in Chinese medicine for thousand of years due to its benefits. Its active components include honokiol and magnolol, which are found in the bark of the tree .
Honokiol and magnolol act as positive modulators of GABA-A receptors and alleviate symptoms of anxiety, depression, and seizures by promoting relaxation . This would help alleviate the fluoroquinolone induced depression and anxiety from the toxicity of the drug.
Magnolia bark has a sedative effect on the body and has been used to promote sleep and ease anxiety. It is also commonly used to support gastrointestinal health. This extract has really helped me and I have used a more powerful extract of magnolia bark called DHH-B, and it kept me from long term anti-depressants.
Modern research shows that magnolia bark has anti-inflammatory, antioxidant, stress, which also helps calm down the mitochondria. These various health benefits are attributed to magnolol and honokiol. I would suggest asking your doctor if this is a good supplement for you to try. Please see the supplement list below.
3. Valerian Root
Valerian has a long tradition of medicinal use, dating back thousands of years. This plant is found in many continents have been used to calm down the body and relieve stress.
The active component in valerian, found mostly in its root, is called valerenic acid. Valerenic acid positively modulates GABA through multiple GABAA receptor subunits .Valerenic acid is the most potent active compund here, since valerian plants without valerenic acid don’t increase GABA receptors
In a few case studies it was shown that valerian is as effective as benzodiazepines for treating anxiety disorders. So why not try this herb as part of combating the issues created from fluoroquinolone anxeity and depression?
4. Lemon Balm Extract
Lemon balm is an herb extract that comes in teas, pills and liquids. The polyphenols and terpenes are beneficial to the body in so many ways. Lemon balm has antioxidant properties, with rosmarinic acid as its most potent psychoactive compound .
Rosmarinic acid increases GABA levels by indirectly inhibiting the enzyme (4-aminobutyrate transaminase) that converts GABA to L-glutamate. Lemon balm extract reduced anxiety, insomnia, stress, and alertness, meanwhile improving memory, mood, and mental processing . If you are looking to add this supplement to your daily regimen then click here.
5. Yoga and light workouts
There are natural ways to also release serotonin, dopamine and GABA. The practice of Yoga and light workouts can increase these beneficial neurotransmitters. I know that physical activity is hard for floxies but eventually working up to these activities can help release your natural production which is really helpful to getting your body back to balance.
In this study they proved that consistent practice of yoga shows an increase in GABA activity in the body. .
6. St Johns Wort
St Johns Wort is a powerful antidepressant and I personally use it and love it so much for keeping me calm!
Research suggests that a number of its active ingredients, including hypericin, hyperforin and adhyperforin, may be responsible for these benefits.
These ingredients appear to increase the levels of chemical messengers in the brain, such as serotonin, dopamine and noradrenaline. These then act to lift and regulate your mood [1
There is strong evidence to support the use of St. John’s wort in the treatment of depression.
In 2016, an in-depth review of 35 studies examined these effects.
It found that St. John’s wort:
- Reduced symptoms of mild and moderate depression more than a placebo
- Reduced symptoms to a similar extent as prescription antidepressants
- Appeared to have fewer side effects than prescription antidepressants
- Doesn’t seem to reduce sex drive, a common side effect of antidepressants
The evidence is clear that natural substances can help balance your GABA receptors and also increase some of your neurotransmitter production in your body. Secondly, please speak to your doctor before taking these supplements. Regenerative Medicine doctors like Dr. Mark Ghalili can help you recover and treat these side effects. You can also see this article here which relates to fluoroquinolone toxicity induced depression.