Interferon-induced Psychosis: When the Treatment Cause the Disease.

Abstract

Introduction

Chronic hepatitis C virus (HCV) infection is a disease that afflicts more than 170 million people worldwide and is a major cause of liver disease, cirrhosis, and hepatocellular carcinoma. Standard pharmacologic treatment for HCV infection is the antiviral combination of pe-gylated interferon (IFN) and ribavirin (RBV). Several psychiatric side effects such as depression, anxiety and even psychosis and cognitive impairment were reported.

Aims and methods

To review the neuropsychiatric side effects of interferon treatment of HCV infection though the study of a case report.

Results

We present a case of a 45-years-old without personal or familiar psychiatric history, admitted in our inpatient unit with psychotic symptoms during the last 2 weeks, consisting of paranoid delusions and aggressive and bizarre behavior. The patient had history of HCV and HIV infection and had initiated treatment with pegylated IFN alpha e RBV in the prior 6 months. Neuroimaging and laboratory tests were done without significant alterations. He was treated with Olanzapine 15 mg od with improvement of the psychotic symptoms and without important side effects. At the time of hospital discharge, psychotic symptoms had almost disappeared and no behavioral disorder was observed.

Conclusions

IFN-associated psychiatric disorders appear to be much more common than previously thought. The increased in pro-inflammatory cytokines in certain psychiatric disorders was widely reported. We believe that the inflammatory setting may be considered as an important further piece in the puzzle in a genetic-environmental diathesis model of the psychiatric diseases.