Background: Mental system adverse drug events (ADEs) linked to triazole antifungal drugs are critical for patient safety due to their widespread use and potential impact on psychiatric health. These ADEs, including hallucinations and psychosis, are underreported and poorly understood, necessitating robust pharmacovigilance. Purpose: This study aimed to identify and analyze signals of psychiatric ADEs associated with five triazole antifungal drugs (Fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) using real-world data. Methods: Data from the FDA Adverse Event Reporting System (FAERS) between January 2004 and December 2022 were mined using the reporting odds ratio (ROR) method. Signals were assessed at standardized MedDRA queries (SMQ) and preferred term (PT) levels, with ROR values and 95% confidence intervals used to detect statistical associations. Key Findings: A total of 880 psychiatric ADE reports were identified, predominantly for fluconazole (249), voriconazole (535), and itraconazole (62). Significant positive signals for mental system ADEs were detected for fluconazole (ROR: 1.39, 95% CI: 1.22–1.57), voriconazole (ROR: 5.38, 95% CI: 4.93–5.87), and itraconazole (ROR: 1.37, 95% CI: 1.07–1.76). Voriconazole showed the strongest association, with hallucinations and paranoia most frequently reported. Posaconazole and isavuconazole exhibited weaker or no statistical associations. Conclusions: Fluconazole, voriconazole, and itraconazole present measurable risks for psychiatric ADEs, underscoring the importance of clinical vigilance and therapeutic drug monitoring during their use. These findings highlight the need for enhanced pharmacovigilance to optimize patient safety in antifungal therapy.