Interferon-induced psychosis as a "psychiatric contraindication" to hepatitis C treatment: a review and case-based discussion

Psychosomatics
Benjamin C SilvermanOliver Freudenreich

Abstract

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. 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. The authors followed a patient with chronic HCV who received interferon and ribavirin and who developed hallucinations ultimately requiring psychiatric hospitalization. Despite treatment with various neuroleptics, the psychosis resolved only when the interferon/ribavirin were discontinued. 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.

Citations

Oct 25, 2011·General Hospital Psychiatry·Mauro García-ToroMiquel Roca
Jan 13, 2018·Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater·Anton SchmickSönke Böttger
Jun 8, 2012·The International Journal of Psycho-analysis·Howard B Levine

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