Interferon-Induced Psychosis as a “Psychiatric Contraindication” to Hepatitis C Treatment: A Review and Case-Based Discussion

Background Hepatitis C (HCV) infection is a major cause of liver disease, cirrhosis, and hepatocellular carcinoma. Interferon-based treatments have the potential to decrease the burden of disease, but are complicated by side effects, including neuropsychiatric symptoms. Objective The authors describ...

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Bibliographic Details
Published in:Psychosomatics (Washington, D.C.) D.C.), 2010-01, Vol.51 (1), p.1-7
Main Authors: Silverman, Benjamin C., M.D, Kim, Arthur Y., M.D, Freudenreich, Oliver, M.D
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Antiviral Agents - adverse effects
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Female
Hepatitis C - drug therapy
Humans
Interferons - adverse effects
Internal Medicine
Medical sciences
Miscellaneous (drug allergy, mutagens, teratogens...)
Other psychotic disorders
Pharmacology. Drug treatments
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychoses, Substance-Induced - diagnosis
Psychoses, Substance-Induced - etiology
Psychoses, Substance-Induced - psychology
Psychosis
Ribavirin - adverse effects
Severity of Illness Index
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Summary:Background Hepatitis C (HCV) infection is a major cause of liver disease, cirrhosis, and hepatocellular carcinoma. Interferon-based treatments have the potential to decrease the burden of disease, but are complicated by side effects, including neuropsychiatric symptoms. Objective The authors described a case of interferon-induced psychosis as a framework to review the literature and discuss the decision to pursue antiviral treatment in psychiatrically ill patients with hepatitis C. Method The authors followed a patient with chronic HCV who received interferon and ribavirin and who developed hallucinations ultimately requiring psychiatric hospitalization. Results Despite treatment with various neuroleptics, the psychosis resolved only when the interferon/ribavirin were discontinued. Conclusion Psychiatric illness should not rule out the possibility of interferon-based therapy, but it calls for close integration of psychiatric and medical care and individualized decision-making based on the biological and psychosocial circumstances of each case.
ISSN:0033-3182
1545-7206
DOI:10.1016/S0033-3182(10)70652-6